Provider Demographics
NPI:1083818017
Name:THE CHESAPEAKE CENTER, INC.
Entity Type:Organization
Organization Name:THE CHESAPEAKE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR GENERALIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:FORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-924-4122
Mailing Address - Street 1:9110 ASPENPARK CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1846
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:703-924-0126
Practice Address - Street 1:6506 LOISDALE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-1824
Practice Address - Country:US
Practice Address - Phone:703-924-4122
Practice Address - Fax:703-924-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004710235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty