Provider Demographics
NPI:1548698152
Name:CHATTERBOX SPEECH AND LANGUAGE THERAPY, LLC
Entity type:Organization
Organization Name:CHATTERBOX SPEECH AND LANGUAGE THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETTHNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-230-1582
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:PATRICK SPRINGS
Mailing Address - State:VA
Mailing Address - Zip Code:24133-0232
Mailing Address - Country:US
Mailing Address - Phone:540-230-1582
Mailing Address - Fax:
Practice Address - Street 1:716 WOOD BROTHERS DR
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:VA
Practice Address - Zip Code:24171-1406
Practice Address - Country:US
Practice Address - Phone:276-694-4488
Practice Address - Fax:276-694-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000563103K00000X
225X00000X, 261QP2000X
VA2202007243235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1548698152Medicaid