1093362436 NPI number — LEAH SCANLON M.S.,CCC-SLP

Table of content: LEAH SCANLON M.S.,CCC-SLP (NPI 1093362436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093362436 NPI number — LEAH SCANLON M.S.,CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCANLON
Provider First Name:
LEAH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S.,CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOHERTY
Provider Other First Name:
LEAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.,CCC-SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093362436
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
158 BRYANT ST NW APT 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20001-7018
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
158 BRYANT ST NW APT 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20001-7018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-299-7144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/21/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SLP001238 . This is a "DC HEALTH" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 08482 . This is a "MARYLAND DEPARTMENT OF HEALTH" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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