Jennifer M. Nick

Individual provider Active NPI Speech-Language Pathologist · Wheeling, WV

NPI 1356528822 · NPPES record last updated Jan 28, 2008

Key facts

NPI
1356528822
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7124 (WV)
Practice address
2203 National Rd
Wheeling, WV 26003-5203
Phone
(304) 243-0300
Fax
(304) 243-0328
NPI assigned
Jan 28, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
7124WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio County Board of Education Past Accepting new patients
Ohio County Board of Education Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7124 WV Yes

Addresses

Primary practice location

2203 National Rd
Wheeling, WV 26003-5203

Mailing address

2203 National Rd
Wheeling, WV 26003-5203
Phone (304) 243-0300

Other identifiers

IdentifierTypeStateIssuer
3810004177MedicaidWV

Other providers in Wheeling, WV

All providers in Wheeling, WV · Speech-Language Pathologist in West Virginia

Sources for this page

Verify at the official NPI Registry.