Individual provider Active NPI

Laura Javonillo, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Clifton, VA
National Provider Identifier
1154559979
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004021 Issued in VA
Practice address
6214 Sandstone Way
Clifton, VA 20124-2438
Phone
(571) 212-6345
NPI assigned
Jul 1, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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 2202004021 VA Primary

Addresses

Primary practice location

6214 Sandstone Way
Clifton, VA 20124-2438

Mailing address

6214 Sandstone Way
Clifton, VA 20124-2438
Phone (571) 212-6345

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
2202004021VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246406400000",
    "number": "1154559979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6214 SANDSTONE WAY",
            "city": "CLIFTON",
            "state": "VA",
            "postal_code": "201242438",
            "telephone_number": "571-212-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6214 SANDSTONE WAY",
            "city": "CLIFTON",
            "state": "VA",
            "postal_code": "201242438",
            "telephone_number": "571-212-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAVONILLO",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2009-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.