Kathleen Egan, CCC-SLP, BCBA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004421 Issued in VA

Practice address

11551 Ivy Bush CT
Reston, VA 20191-2253

Phone

(571) 216-6945

NPI assigned

May 18, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katie Egan Professional name

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.

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1225485477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11551 IVY BUSH CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201912253",
            "telephone_number": "571-216-6945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11551 IVY BUSH CT",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201912253",
            "telephone_number": "571-216-6945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGAN",
        "first_name": "KATHLEEN",
        "credential": "CCC-SLP, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "VA",
            "license": "0133000724",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "EGAN",
            "credential": "CCC-SLP, BCBA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Madison Eagen, BCBA, LBA
• Anne Rose Navarro Eapen, M.D.
• Richard James Edgar, MD
• Phebe Edillon, OTD, OTR/L
• Alicia Edwards
• Ehs Corporate Care
• Kyle Eiben, MS, OTR/L
• Paige Allison Einstein, R.D.
• Alexa Eisenberg
• Yasir B. Elamin, MD

• Speech-Language Pathologist in Reston, VA
• Providers in Reston, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.