Jaclyn Favale

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202010106 Issued in VA

Practice address

601 Catoctin Cir NE
Leesburg, VA 20176-4964

Phone

(347) 556-3920

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1336764786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CHATWELL TER",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 CATOCTIN CIR NE",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764964",
            "telephone_number": "347-556-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVALE",
        "first_name": "JACLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Farinas, MS, RDN
• Corey Lynn Farrell, FNP-BC
• Rosanna Patricia Farrell, MSW
• Maryam Farsi, PT.
• Sima Fartash, MD
• Addison S Fay
• Megan Kay Fazenbaker, LPC
• Kurt Ellis Fedors, PT
• Thomas Archibald Feely, MD
• Debora Y Feeney, NP

• Speech-Language Pathologist in Leesburg, VA
• Providers in Leesburg, 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 Jul 18, 2022; 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.