Provider Demographics
NPI:1891776886
Name:STAHL, JANET M (MS SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:M
Last Name:STAHL
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:M
Other - Last Name:LYONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:818 NEWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-1116
Mailing Address - Country:US
Mailing Address - Phone:757-473-8016
Mailing Address - Fax:757-473-3580
Practice Address - Street 1:818 NEWTOWN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-1116
Practice Address - Country:US
Practice Address - Phone:757-473-8016
Practice Address - Fax:757-473-3580
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4980093OtherVIRGINIA PREMIER HEALTH P
11230802OtherCAQH
219567OtherANTHEM BLUE CROSS
35062OtherOPTIMA
VA4980093Medicaid
7039322OtherAETNA
VA9116460OtherMEDICAID DME
350034OtherOPTIMA GROUP
64 00313OtherUNITED HEALTH CARE
007328OtherANTHEM BLUE CROSS GROUP
5275769OtherAETNA GROUP
35062OtherOPTIMA