Stephanie Keenan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008863 Issued in VA

Practice address

8308 Timber Brook LN
Springfield, VA 22153-2254

Phone

(330) 679-8779

NPI assigned

Jan 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Breakthrough Communication and Wellness, LLC

  • Speech-Language Pathologist
  • Springfield, VA
  • NPI 1982193116
  NPD (past) Authorized official
• Breakthrough Communication and Wellness, LLC

  • Speech-Language Pathologist
  • Grovetown, GA
  • NPI 1326555186
  NPD (past) Authorized official

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1699282574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 WAITES DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 TIMBER BROOK LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221532254",
            "telephone_number": "330-679-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEENAN",
        "first_name": "STEPHANIE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-02",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP008723",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP09386",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KCB Play Institute Inc
• Abigail Kearney
• Matthew John Keast, D.P.M.
• Rebecca Sevillano Keegan
• Audrey Elizabeth Keen, PA-C
• Keg Ventures Inc.
• Melanie Kellett
• Jeremiah Joseph Kelliher Jr., DDS
• Sean Patrick Kelliher, DDS
• Kemet Health One LLC

• Speech-Language Pathologist in Springfield, VA
• Providers in Springfield, 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 3, 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.