Healthcare Provider Details

I. General information

NPI: 1548698152
Provider Name (Legal Business Name): CHATTERBOX SPEECH AND LANGUAGE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2013
Last Update Date: 10/20/2022
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 WOOD BROTHERS DR
STUART VA
24171-1406
US

IV. Provider business mailing address

PO BOX 232
PATRICK SPRINGS VA
24133-0232
US

V. Phone/Fax

Practice location:
  • Phone: 276-694-4488
  • Fax: 276-694-4481
Mailing address:
  • Phone: 540-230-1582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2202007243
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133000563
License Number StateVA

VIII. Authorized Official

Name: BETTHNEY O'CONNELL
Title or Position: OWNER
Credential:
Phone: 540-230-1582