Individual provider Active NPI

Rachel Z Marvin, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Leesburg, VA
National Provider Identifier
1114656022
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202009962 Issued in VA
Practice address
40989 Grenata Preserve PL
Leesburg, VA 20175-8720
Phone
(443) 765-7151
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202009962 VA Primary

Addresses

Primary practice location

40989 Grenata Preserve PL
Leesburg, VA 20175-8720

Mailing address

40989 Grenata Preserve PL
Leesburg, VA 20175-8720
Phone (443) 765-7151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2202009962VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1114656022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40989 GRENATA PRESERVE PL",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201758720",
            "telephone_number": "443-765-7151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40989 GRENATA PRESERVE PL",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201758720",
            "telephone_number": "443-765-7151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARVIN",
        "first_name": "RACHEL",
        "middle_name": "Z",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202009962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.