MEDICARE: LYNN CLEVERSLEY M.S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202011084	VA
2	235Z00000X	Speech-Language Pathologist	SZ10782	FL

General Provider Information

NPI Number	:	1427748029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN CLEVERSLEY M.S

Provider Business Mailing Address
First Line	:	3520 EVANGELINE ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-3107
Country	:	US
Telephone Number	:	716-393-7404
Fax Number	:

Provider Business Practice Location Address
First Line	:	3520 EVANGELINE ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23502-3107
Country	:	US
Telephone Number	:	716-393-7404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2023
Last Update Date	:	02/13/2026

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Directions to “ LYNN CLEVERSLEY M.S” Practice Location

Language	Start Address	Practice Location

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