Healthcare Provider Details

I. General information

NPI: 1245975564
Provider Name (Legal Business Name): SPEECH LANGUAGE CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1591 PORT REPUBLIC RD
ROCKINGHAM VA
22801-3517
US

IV. Provider business mailing address

15245 SHADY GROVE RD STE 110
ROCKVILLE MD
20850-7202
US

V. Phone/Fax

Practice location:
  • Phone: 678-889-0045
  • Fax:
Mailing address:
  • Phone: 678-889-0045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: GRANT SCHAFLE
Title or Position: CEO
Credential:
Phone: 707-499-1164