Laura Jean Manning, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202005101 Issued in VA

Practice address

8270 Willow Oaks Corporate Dr
Fairfax, VA 22031

Phone

(703) 227-2664

NPI assigned

Mar 29, 2007

Reactivated

Mar 27, 2018

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

Other identifiers 1

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": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525910400000",
    "number": "1376663989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8270 WILLOW OAKS CORPORATE DR STE",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-227-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8270 WILLOW OAKS CORPORATE DR",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-227-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2018-05-10",
        "deactivation_date": "2011-05-05",
        "reactivation_date": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05449",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF AUDIOLOGY AND SPEECH LANGUAGE PATHOLOGY",
            "identifier": "2202005101",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex Dertad Manguikian, M.D., PH.D.
• Kanan D Maniar, M.D.
• Timothy Patrick Manley, M.S.W.
• Lauryn Mann
• Susan E Mannan, M.D.
• Anup Manoharan, M.D.
• Manor Care-Fair Oaks of Fairfax VA LLC
• Sandra M Mansfield, LCSW
• Max Manson
• Darlene Mansoor, M.D.

• Speech-Language Pathologist in Fairfax, VA
• Providers in Fairfax, 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 May 10, 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.