Healthcare Provider Details

I. General information

NPI: 1477101343
Provider Name (Legal Business Name): DENISE L CARMINES M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N 9TH ST
RICHMOND VA
23219-1933
US

IV. Provider business mailing address

3806 CLEVELAND ST
TOMS RIVER NJ
08755-2307
US

V. Phone/Fax

Practice location:
  • Phone: 908-692-5544
  • Fax:
Mailing address:
  • Phone: 908-692-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS01002600
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number200001365
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202010455
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: