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NPI Code Detail

MEDICARE: CHILDHOOD LANG CNTR AT RICH. INC.

MEDICARE: CHILDHOOD LANG CNTR AT RICH. INC.
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
1235Z00000XSpeech-Language Pathologist
2231H00000XAudiologist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13822946OTHERVACIGNA PPO
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3195246OTHERVABCBS
4052550OTHERVABCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598872590
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDHOOD LANG CNTR AT RICH. INC.
Provider Business Mailing Address
First Line : 4202 HERMITAGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23227-3755
Country : US
Telephone Number : 804-266-6699
Fax Number : 804-264-5988
Provider Business Practice Location Address
First Line : 4202 HERMITAGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23227-3755
Country : US
Telephone Number : 804-266-6699
Fax Number : 804-264-5988
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. ROBIN KAYE OLIVIER
Credential : CCC-SLP
Telephone Number : 804-266-6699
Provider Enumeration Date : 08/24/2006
Last Update Date : 09/11/2025

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