Provider Demographics
NPI:1780825364
Name:LONGERBEAM, MARSHA S (PHD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:S
Last Name:LONGERBEAM
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:MARSHA
Other - Middle Name:S
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:118 HARMON PLACE
Mailing Address - Street 2:
Mailing Address - City:STEPHEN CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655
Mailing Address - Country:US
Mailing Address - Phone:304-267-3595
Mailing Address - Fax:
Practice Address - Street 1:131 W. GRACE STREET
Practice Address - Street 2:
Practice Address - City:HARRISONBERG
Practice Address - State:VA
Practice Address - Zip Code:22807
Practice Address - Country:US
Practice Address - Phone:540-568-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP1184235Z00000X
VA2202001053235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist