Provider Demographics
NPI:1396245759
Name:FARRALL, CHELSEA L (CF-SLP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:L
Last Name:FARRALL
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 L ST NW APT 833
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2947
Mailing Address - Country:US
Mailing Address - Phone:443-472-1176
Mailing Address - Fax:
Practice Address - Street 1:1487 CHAIN BRIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-5723
Practice Address - Country:US
Practice Address - Phone:703-941-7757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VA2204000932235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician