Provider Demographics
NPI:1235477761
Name:SENSEABILITIES PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:SENSEABILITIES PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PICKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:757-410-2816
Mailing Address - Street 1:1779 TAIT TER
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-1043
Mailing Address - Country:US
Mailing Address - Phone:757-410-2816
Mailing Address - Fax:
Practice Address - Street 1:1779 TAIT TER
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23509-1043
Practice Address - Country:US
Practice Address - Phone:757-410-2816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004739235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA496647Medicare UPIN
VA004979907Medicaid