Healthcare Provider Details

I. General information

NPI: 1326973454
Provider Name (Legal Business Name): SHAELYN COHICK LPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 BATTLEFIELD BLVD S STE 200
CHESAPEAKE VA
23322-4800
US

IV. Provider business mailing address

115 W TAZEWELL ST STE 3B
NORFOLK VA
23510-1820
US

V. Phone/Fax

Practice location:
  • Phone: 757-233-4790
  • Fax: 757-938-5729
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306606357
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: