NPIMap

Organization Active NPI

Dynamic Speech Therapy, LLC

  • Speech-Language Pathologist
  • Sterling, VA
National Provider Identifier
1356646665
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004993 Issued in VA
Legal business name
DYNAMIC SPEECH THERAPY, LLC
Practice address
21751 Ladbroke Grove CT
Sterling, VA 20166-9290
Phone
(571) 244-0316
Fax
(703) 421-1212
NPI assigned
Jan 18, 2011
Last updated
Jan 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Authorized official

Name
Mrs. Keenan Paige Glazar, M.S., CCC-SLP, LNPI 1306361126
Title
Owner/Speech Language Pathologist
Phone
(571) 244-0316

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 2202004993 VA Primary

Addresses

Primary practice location

21751 Ladbroke Grove CT
Sterling, VA 20166-9290

Mailing address

21751 Ladbroke Grove CT
Sterling, VA 20166-9290
Phone (571) 244-0316

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": "1295308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295308800000",
    "number": "1356646665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21751 LADBROKE GROVE CT",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201669290",
            "telephone_number": "571-244-0316",
            "fax_number": "703-421-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21751 LADBROKE GROVE CT",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201669290",
            "telephone_number": "571-244-0316",
            "fax_number": "703-421-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-18",
        "last_updated": "2011-01-18",
        "status": "A",
        "authorized_official_last_name": "GLAZAR",
        "authorized_official_first_name": "KEENAN",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER/SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "571-244-0316",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S., CCC-SLP, L"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; 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.