Jennifer Michelle Bass
Individual provider Active NPI Speech-Language Pathologist · Centreville, VA
NPI 1477991990 · NPPES record last updated Aug 17, 2023
Key facts
- NPI
- 1477991990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2202007003 (VA)
- Practice address
- 13890 Braddock Rd
Suite 205
Centreville, VA 20121-2435 - Phone
- (540) 720-2261
- Fax
- (540) 720-5660
- NPI assigned
- Jun 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202007003 | VA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Play2Learn Therapy LLC | Current | Accepting new patients | |
| Fleming Therapy Services, LLC | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202007003 | VA | Yes |
Addresses
Primary practice location
13890 Braddock Rd
Suite 205
Centreville, VA 20121-2435
Mailing address
2765 Jefferson Davis Hwy
Suite 209
Stafford, VA 22554-8331
Phone (540) 720-2261
Other providers in Centreville, VA
- Jessica Barrett
- Sarah Barrows
- Bandana Bashyal
- Reem Basit I
- Michail S Baskaron
- Gankhuleg Batsuuri
- Bawa Dentistry PLLC
- Beam Pediatric Therapy, LLC
- Willie Keith Beasley
- Behavioral Expectations LLC
All providers in Centreville, VA · Speech-Language Pathologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.