Provider Demographics
NPI:1225035520
Name:READ, CAROLE STEPHENS (MED)
Entity Type:Individual
Prefix:MRS
First Name:CAROLE
Middle Name:STEPHENS
Last Name:READ
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:V.
Other - Middle Name:CAROLE
Other - Last Name:STEPHENS READ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED
Mailing Address - Street 1:4701 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1105
Mailing Address - Country:US
Mailing Address - Phone:434-384-3240
Mailing Address - Fax:
Practice Address - Street 1:1330 OAK LN
Practice Address - Street 2:SUITE 204
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-2513
Practice Address - Country:US
Practice Address - Phone:434-947-3125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101000316237600000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA165675OtherSOUTHERN HEALTH
VA009450491Medicaid
VA541250449OtherFEDERAL TAX ID
VA009109340Medicaid
VA086626OtherANTHEM
VA541250449OtherFEDERAL TAX ID
VA009450491Medicaid