Chrissondria Lynn Mangrum, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP-0607 Issued in WV

Practice address

213 W McDonald Ave
Man, WV 25635-1112

Phone

(304) 583-9299

NPI assigned

Apr 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336364033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 W MCDONALD AVE",
            "city": "MAN",
            "state": "WV",
            "postal_code": "256351112",
            "telephone_number": "304-583-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W MCDONALD AVE",
            "city": "MAN",
            "state": "WV",
            "postal_code": "256351112",
            "telephone_number": "304-583-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGRUM",
        "first_name": "CHRISSONDRIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "SLP-0607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylee Lawson
• Lincoln County Primary Care Center Inc (Southern West Virginia Health System-Man)
• Lincoln County Primary Care Center, Inc (Pioneer Health Center)
• Lincoln County Primary Care Center, Inc.
• Man Rexcellence Program
• Cheryl Marie Marcum
• Mary Margaret Maynard
• Mountain State Chiropractic
• Angela Muncy
• Amberia Shea Nelson

• Speech-Language Pathologist in Man, WV
• Providers in Man, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.