Provider Demographics
NPI:1215950548
Name:BECKLEY SPEECH THERAPY INC
Entity type:Organization
Organization Name:BECKLEY SPEECH THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELISSA
Authorized Official - Middle Name:G
Authorized Official - Last Name:LINDSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:304-252-1925
Mailing Address - Street 1:104 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2726
Mailing Address - Country:US
Mailing Address - Phone:304-252-1925
Mailing Address - Fax:304-253-2526
Practice Address - Street 1:116 N VANCE DR
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-4913
Practice Address - Country:US
Practice Address - Phone:304-252-1925
Practice Address - Fax:302-253-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP0057235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty