Jessica Dehaven

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10572 Issued in NC

Practice address

300 E Arlington Blvd
Ste 2a
Greenville, NC 27858-5037

Phone

(252) 916-1029

NPI assigned

Aug 27, 2013

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 21, 2022.

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1134553159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2417",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285902417",
            "telephone_number": "252-916-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E ARLINGTON BLVD",
            "address_2": "STE 2A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585037",
            "telephone_number": "252-916-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lauren Deen, LCSWA
• Deeply Rooted Home Care Incorporated
• Jennifer Marie Defazio, MD
• Benjamin C Degner, MD
• Michelle Dehart, PHARMD, CPP
• Eric Arthur Deigan, MD
• Arlene De Leon Delacruz, PT
• Agnes Blanche Delaney, PA
• Gage Richard Delany
• Courtney Renee Delavern, PA-C

• All providers in Greenville, NC
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.