Healthcare Provider Details

I. General information

NPI: 1598688442
Provider Name (Legal Business Name): SLP SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5129 STANART ST
NORFOLK VA
23502-3406
US

IV. Provider business mailing address

5129 STANART ST
NORFOLK VA
23502-3406
US

V. Phone/Fax

Practice location:
  • Phone: 757-524-5857
  • Fax: 757-277-0151
Mailing address:
  • Phone: 757-524-5857
  • Fax: 757-277-0151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CORIE JONES
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 757-892-0757