Denise McClung Desando

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22022007625 Issued in VA

Practice address

20 Pendleton Rd
Fredericksburg, VA 22405-3041

Phone

(540) 373-7366

Fax

(540) 371-3788

NPI assigned

Feb 7, 2018

Last updated

Feb 7, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1517961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517961600000",
    "number": "1912406760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 CAMDEN DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052032",
            "telephone_number": "540-373-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PENDLETON RD",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224053041",
            "telephone_number": "540-373-7366",
            "fax_number": "540-371-3788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESANDO",
        "first_name": "DENISE",
        "middle_name": "MCCLUNG",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-07",
        "last_updated": "2018-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "22022007625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY",
            "identifier": "2202007625",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Fredericksburg, VA
• Providers in Fredericksburg, 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 7, 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.