Stephanie J. Lucy, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Boydton, VA
NPI 1669976734 · NPPES record last updated Mar 22, 2018
Key facts
- NPI
- 1669976734
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2203000563 (VA)
- Practice address
- 175 Mayfield Dr
Boydton, VA 23917-2817 - Phone
- (434) 738-6111
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2203000563 | VA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | 2203000563 | VA | Yes |
Addresses
Primary practice location
175 Mayfield Dr
Boydton, VA 23917-2817
Mailing address
1008 Charles St
South Hill, VA 23970-1304
Phone (434) 865-0208
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2203000563 | Medicaid | VA |
Other providers in Boydton, VA
- Robin H. Jennings
- Journey to Peace, LLC
- KLM Pediatric Therapy Services
- Carolyn B Leach
- T'Onna Logan
- Curtis Mangum
- Mecklenburg County Board of Supervisors
- Mecklenburg County Public Schools
- Mecklenburg Family Practice
- Linda Ray Montgomery
All providers in Boydton, 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 Mar 22, 2018. 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.