Elaine Tucker Hagan, MA SLP CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202004878 Issued in VA

Practice address

5804 Granby St
Norfolk, VA 23505-4813

Phone

(757) 692-6574

NPI assigned

Apr 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1235456633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 GARDEN LN",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229634285",
            "telephone_number": "757-692-6574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5804 GRANBY ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054813",
            "telephone_number": "757-692-6574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "ELAINE",
        "middle_name": "TUCKER",
        "name_prefix": "Mrs.",
        "credential": "MA SLP CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235456633",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara S Hadden, FNP
• Frank Ronald Hadden Jr.
• Laura Jacqueline Hadley, CSA
• Stephanie Margaret Hadley, PA
• Allyson Louise Hagan, CTRS
• Sarah Tam Hagan, P.A.
• Yara Hage Diab, MD
• Patrick George Haggerty, MD
• Sharon Hagins, RRT
• Hague Center for Cosmetic & Plastic Surgery Inc

• Speech-Language Pathologist in Norfolk, VA
• Providers in Norfolk, 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 Apr 18, 2018; 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.