Individual provider Active NPI

Elizabeth Michelle Leon-Kirtland, M.S., CF-SLP

  • Speech-Language Pathologist
  • Virginia Beach, VA
National Provider Identifier
1194996074
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204000443 Issued in VA
Practice address
5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone
(757) 455-5000
Fax
(757) 319-4142
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Speech-Language Pathologist 235Z00000X 2204000443 VA Primary

Addresses

Primary practice location

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631

Mailing address

5604 Virginia Beach Blvd Ste 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

Other practice location 1

9990 County Farm Rd
Riverside, CA 92503-3542
Phone (951) 358-4647

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1194996074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000",
            "fax_number": "757-319-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 VIRGINIA BEACH BLVD STE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234625631",
            "telephone_number": "757-455-5000",
            "fax_number": "757-319-4142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9990 County Farm Rd",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033542",
            "country_code": "US",
            "telephone_number": "951-358-4647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEON-KIRTLAND",
        "first_name": "ELIZABETH",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.