Healthcare Provider Details

I. General information

NPI: 1215950548
Provider Name (Legal Business Name): BECKLEY SPEECH THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 N VANCE DR
BECKLEY WV
25801-4913
US

IV. Provider business mailing address

104 MICHIGAN AVE
BECKLEY WV
25801-2726
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-1925
  • Fax: 302-253-2526
Mailing address:
  • Phone: 304-252-1925
  • Fax: 304-253-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP0057
License Number StateWV

VIII. Authorized Official

Name: MS. ELISSA G LINDSAY
Title or Position: OWNER PRESIDENT
Credential: MS
Phone: 304-252-1925