TIDEWATER THERAPY FOR CHILDREN, PC (NPI# 1174549000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174549000 |
| Entity Type | Organization |
| Organization Name | TIDEWATER THERAPY FOR CHILDREN, PC |
| Practice Address |
4016 Raintree Rd Suite 240 Chesapeake VA 23321-3700 |
| Practice Telephone | 7574882864 |
| Practice Fax Number | 7574884735 |
| Mailing Telephone | 7574882864 |
| Mailing Fax Number | 7574884735 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. JESSICA ML DUPREE (OFFICE/INSURANCE MANAGER) |
| Authorized Official Telephone | 7574882864 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | OPTIMA ST PROVIDER # | 57442 | 01 |
| VA | ANTHEM BC & HK ST PROV # | 194324 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881814671 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Road, Suite 240, Chesapeake, VA 23321 | 2007-04-26 |
| 1316051287 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-08-18 |
| 1386667400 | Tidewater Therapy for Children, PC | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-07-26 |
| 1285657874 | Tidewater Therapy for Children, PC | Occupational Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2006-07-25 |
| Street Address |
4016 RAINTREE RD SUITE 240 |
| City | CHESAPEAKE |
| State | VA |
| Zip Code | 23321-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194324962 | Rebecca Schwartzman | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2020-10-22 |
| 1053960179 | Claire Allyson Laibstain | Assistant Behavior Analyst | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2019-09-11 |
| 1194221473 | Kendall Buonviri | Behavioral Analyst | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2018-04-04 |
| 1598271314 | Joi Deannia Rountree | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-15 |
| 1518472448 | Elizabeth Fortune | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-14 |
| 1710492640 | Destinee Monae Romein | Behavior Technician | 4016 Raintree Rd, Chesapeake, VA 23321-3700 | 2017-12-14 |
| 1457701328 | Lara Mccarter | Speech-Language Pathologist | 4016 Raintree Rd, Suite 100 A, Chesapeake, VA 23321-3700 | 2016-06-21 |
| 1649667056 | Janet Webb | Speech-Language Pathologist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-04-23 |
| 1851782601 | Sharon Miller | Occupational Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-02-16 |
| 1962890392 | Marci Knight | Physical Therapist | 4016 Raintree Rd, Suite 240, Chesapeake, VA 23321-3700 | 2015-01-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538475 | Yvonne Cotton | Social Worker | 3201 Churchland Blvd Suite 3, Chesapeake, VA 23321 | 2020-11-04 |
| 1073120242 | Peace In Life, LLC. | Custodial Care Facility | 3101 American Legion Road 21a, Chesapeake, VA 23321 | 2020-09-30 |
| 1497382337 | Diversified Transportation Solutions | Meals | 4940 Portsmouth Blvd. #222, Chesapeake, VA 23321 | 2020-03-23 |
| 1952895344 | Jasmine Wilkins | Private Vehicle | 4112 Jennifer Cres, Chesapeake, VA 23321 | 2018-06-19 |
| 1891219804 | P & S Home Health Care Solutions | Home Health | 3217 Western Branch Blvd, Suite B, Chesapeake, VA 23321 | 2017-08-01 |
| 1316467145 | Chelsea Ellison | Occupational Therapist | 3253 Taylor Rd Ste 200, Chesapeake, VA 23321 | 2017-06-22 |
| 1932655313 | Bhg Xli, LLC | Clinic/Center | 3322 Western Branch Blvd Ste A, Chesapeake, VA 23321 | 2016-08-26 |
| 1891189429 | Kelly C Diguilio | Social Worker | 4142 Chesapeake Square Blvd, Chesapeake, VA 23321 | 2015-03-20 |
| 1447665336 | Clancey Page | Behavioral Analyst | 4016 Raintree Rd Ste 200a, Chesapeake, VA 23321 | 2014-06-30 |
| 1558786228 | Mary Elizabeth Whitley | Home Health Aide | 3933 Galleon Dr., Chesapeake, VA 23321 | 2014-03-04 |
| Find all providers in zip 23321 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819529 | Takayla S Kendrick | Speech-Language Pathologist | 2008 Dock Landing Rd # L, Chesapeake, VA 23321-3512 | 2020-07-29 |
| 1922622844 | Wendy Childress | Speech-Language Pathologist | 525 Giles Dr, Chesapeake, VA 23322-3849 | 2020-06-05 |
| 1063061547 | Jennifer Lees | Speech-Language Pathologist | 3 Private Drive 10659, Chesapeake, OH 45619-6000 | 2019-09-08 |
| 1922653401 | Nicole Renee Pelon | Speech-Language Pathologist | 912 Redstart Ave, Chesapeake, VA 23324-1840 | 2019-08-02 |
| 1417516758 | Lillie M. Wheeler | Speech-Language Pathologist | 4201 Hawksley Dr, Chesapeake, VA 23321-5427 | 2019-06-11 |
| 1093372575 | Athena Spingler | Speech-Language Pathologist | 1955 Deal Dr, Chesapeake, VA 23323-3218 | 2019-05-21 |
| 1316428162 | John Davanzo | Speech-Language Pathologist | 900 Bells Creek Ct, Chesapeake, VA 23322-7426 | 2018-08-28 |
| 1477030518 | Sharon Spellman | Speech-Language Pathologist | 705 Pebble Quay, Chesapeake, VA 23320-2022 | 2018-07-22 |
| 1972098945 | Brynne Burkett | Speech-Language Pathologist | 1997 Hawk Blvd, Chesapeake, VA 23322-2125 | 2018-06-22 |
| 1629563630 | Lorraine Boardley Thompson IIi | Speech-Language Pathologist | 436 Providence Rd, Chesapeake, VA 23325-4603 | 2018-06-22 |
| Find all providers in CHESAPEAKE | ||||
| City | CHESAPEAKE |
| Zip Code | 23321 |
Please comment or provide details below to improve the information on TIDEWATER THERAPY FOR CHILDREN, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.