Individual provider Active NPI

Hannah Haelim Song

  • Speech-Language Pathologist
  • Fairfax, VA
National Provider Identifier
1669248118
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202011714 Issued in VA
Practice address
8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4530
Phone
(310) 800-6139
NPI assigned
Nov 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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 2202011714 VA Primary

Addresses

Primary practice location

8270 Willow Oaks Corporate Dr
Fairfax, VA 22031-4530

Mailing address

5504 Columbia Pike
Apartment 703
Arlington, VA 22204
Phone (310) 800-6139

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2202011714VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Network PastSince Dec 1, 2023 Accepting new patients
Pediatric Therapy Network PastSince Dec 1, 2023 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1669248118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5504 COLUMBIA PIKE",
            "address_2": "APARTMENT 703",
            "city": "ARLINGTON",
            "state": "VA",
            "postal_code": "22204",
            "telephone_number": "310-800-6139"
        },
        {
            "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": "220314530",
            "telephone_number": "310-800-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "HANNAH",
        "middle_name": "HAELIM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-27",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202011714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.