Healthcare Provider Details

I. General information

NPI: 1164266276
Provider Name (Legal Business Name): MARY KATHERINE FOLEY M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21630 RIDGETOP CIR
STERLING VA
20166-6564
US

IV. Provider business mailing address

7605 PARTRIDGE BERRY LN
CLIFTON VA
20124-2118
US

V. Phone/Fax

Practice location:
  • Phone: 571-449-6281
  • Fax:
Mailing address:
  • Phone: 703-340-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2204001409
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202011938
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: