Organization Active NPI

Kids Express Speech Therapy, LLC

  • Speech-Language Pathologist
  • Fairfax, VA
National Provider Identifier
1275355364
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
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

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Mrs. Gwendolyn Goldstein, MA, CCC-SLPNPI 1447709357
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)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
2202007645OtherVASLP

National Provider Directory

National Provider Directory

Practitioners & 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.

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.

Verify at the official NPI Registry.