Active NPI
Kids Express Speech Therapy, LLC
- Speech-Language Pathologist
- Fairfax, VA
National Provider Identifier
1275355364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- KIDS EXPRESS SPEECH THERAPY, LLC
- Practice address
- 12277 Engelmann Oak LN
Fairfax, VA 22030-9069 - Phone
- (703) 963-1566
- NPI assigned
- Oct 29, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Gwendolyn Goldstein, MA, CCC-SLP
- Title
- Speech Language Pathologist
- Phone
- (703) 963-1566
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
12277 Engelmann Oak LN
Fairfax, VA 22030-9069
Mailing address
12277 Engelmann Oak LN
Fairfax, VA 22030-9069
Phone (703) 963-1566
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2202007645 | Other | VA | SLP |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Speech-Language Pathologist
- Fairfax, VA
- NPI 1447709357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1774310400000",
"number": "1275355364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12277 ENGELMANN OAK LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220309069",
"telephone_number": "703-963-1566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12277 ENGELMANN OAK LN",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220309069",
"telephone_number": "703-963-1566"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KIDS EXPRESS SPEECH THERAPY, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-29",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A",
"authorized_official_last_name": "GOLDSTEIN",
"authorized_official_first_name": "GWENDOLYN",
"authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
"authorized_official_telephone_number": "703-963-1566",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "MA, CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLP",
"identifier": "2202007645",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.