Active NPI
Elaine Marie Mehlberg, SLP
- Speech-Language Pathologist
- Lansdowne, VA
National Provider Identifier
1154658672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202005926
- Practice address
- 19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701 - Phone
- (703) 858-7620
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202005926 | VA | Primary |
Addresses
Primary practice location
19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701
Mailing address
19465 Deerfield Ave
Suite 201
Lansdowne, VA 20176-1701
Phone (703) 858-7620
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558304253 | Medicaid | VA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2202005926 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1154658672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19465 DEERFIELD AVE",
"address_2": "SUITE 201",
"city": "LANSDOWNE",
"state": "VA",
"postal_code": "201761701",
"telephone_number": "703-858-7620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19465 DEERFIELD AVE",
"address_2": "SUITE 201",
"city": "LANSDOWNE",
"state": "VA",
"postal_code": "201761701",
"telephone_number": "703-858-7620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHLBERG",
"first_name": "ELAINE",
"middle_name": "MARIE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-04",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202005926",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1558304253",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lansdowne, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.