Jessica Gabriel Driscoll, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202010278 Issued in VA

Practice address

1024 Fairhaven Rd
Chesapeake, VA 23322-4665

Phone

(757) 286-7869

NPI assigned

Feb 3, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1407509912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 FAIRHAVEN RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224665",
            "telephone_number": "757-286-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 FAIRHAVEN RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233224665",
            "telephone_number": "757-286-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRISCOLL",
        "first_name": "JESSICA",
        "middle_name": "GABRIEL",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202010278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdriscoll@tidewatertheapy.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Tidewater Therapy for Children, PC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4016 Raintree Rd",
            "address_2": "Suite 240",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233213700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dr. Veronica B. Sullivan, OD, PLLC
• Dr.'S Fritz & Olson, P.C.
• Dr.Jamesl Singletonjr DPM
• Jenelle Drake, MA, LMFT, LPC
• Robin L Drees, M.S., CF-SLP
• DRS Bussey Mayo & Archer LTD
• DRS Bussey Mayo Archer LTD
• DRS. Moreschell & Wright, Inc.
• Lukas A Du Plessis
• William J Duane, PHD

• Speech-Language Pathologist in Chesapeake, VA
• Providers in Chesapeake, 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 Feb 3, 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.