Individual provider Active NPI

Emily Marie Collado-Lugo

  • Speech-Language Pathologist
  • Manassas, VA
National Provider Identifier
1376044925
Registry record updated Feb 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2204000007 Issued in VA
Practice address
14715 Bristow Rd
Manassas, VA 20112-3945
Phone
(703) 791-7200
NPI assigned
Feb 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2204000007 VA Primary

Addresses

Primary practice location

14715 Bristow Rd
Manassas, VA 20112-3945

Mailing address

4708 Grand Masters Way
Woodbridge, VA 22192-5553
Phone (787) 408-6846

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2204000007VAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519689600000",
    "number": "1376044925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4708 GRAND MASTERS WAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221925553",
            "telephone_number": "787-408-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14715 BRISTOW RD",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201123945",
            "telephone_number": "703-791-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLADO-LUGO",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-27",
        "last_updated": "2018-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2204000007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.