Individual provider Active NPI

Brianne Colleen Lipke, CF-SLP

  • Speech-Language Pathologist
  • Woodbridge, VA
National Provider Identifier
1124782354
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204000846 Issued in VA
Practice address
15201 Neabsco Mills Rd
Woodbridge, VA 22191-4005
Phone
(703) 583-1405
Fax
(703) 580-7280
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 2204000846 VA Primary

Addresses

Primary practice location

15201 Neabsco Mills Rd
Woodbridge, VA 22191-4005

Mailing address

817 E Grandview Blvd Apt 302
Erie, PA 16504-2666
Phone (814) 758-7312

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

State licenses

LicenseStateTypeSpecialty
2204000846VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1124782354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 E GRANDVIEW BLVD APT 302",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042666",
            "telephone_number": "814-758-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15201 NEABSCO MILLS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914005",
            "telephone_number": "703-583-1405",
            "fax_number": "703-580-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPKE",
        "first_name": "BRIANNE",
        "middle_name": "COLLEEN",
        "name_prefix": "Mrs.",
        "credential": "CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.