NPIMap

Organization Active NPI

Tidewater Speech and Language Services

Doing business as Norfolk Speech and Language Services

  • Speech-Language Pathologist
  • Norfolk, VA
National Provider Identifier
1073989240
Registry record updated Aug 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006671 Issued in VA
Legal business name
TIDEWATER SPEECH AND LANGUAGE SERVICES
Doing business as
Norfolk Speech and Language Services
Practice address
110 Kingsley LN
Suite 209
Norfolk, VA 23505-4614
Phone
(757) 423-1933
NPI assigned
Aug 11, 2015
Last updated
Aug 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Pamela Crenshaw, MA CCC-SLPNPI 1104174077
Title
Owner/Director
Phone
(757) 423-1933

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202006671 VA Primary

Addresses

Primary practice location

110 Kingsley LN
Suite 209
Norfolk, VA 23505-4614

Mailing address

110 Kingsley LN
Suite 209
Norfolk, VA 23505-4614

Other names 1

  • Norfolk Speech and Language Services Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439251200000",
    "number": "1073989240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 209",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 KINGSLEY LN",
            "address_2": "SUITE 209",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054614",
            "telephone_number": "757-423-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER SPEECH AND LANGUAGE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-11",
        "status": "A",
        "authorized_official_last_name": "CRENSHAW",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "757-423-1933",
        "authorized_official_credential": "MA CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Norfolk Speech and Language Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.