Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1346807476 Individual Practitioner Female Practitioner

Elyse Wahlquist Van Wagenen , MA CCC SLP

Speech-Language Pathologist • Bristol, FL

Professional Overview & Biography Verified Profile Summary

Elyse Van Wagenen, MA CCC SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Bristol, FL. Practice services are available at 11287 NW STATE ROAD 20 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

11287 Nw State Road 20

Bristol, FL 323213414

Telephone 8506944420
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Bristol, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 16.7 Yrs
Regional Practice Density
4 Specialists

Practicing in Bristol, FL (11640 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-12-02
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SA17587

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License DC SLPCF000042

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Secondary Practice Locations

2930 Capital Medical Blvd

Tallahassee, FL 323084408

Phone: 8506944420

2600 Douglass Rd Se

Washington, Dc, DC 20020

Phone: 8506944429

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
📍
Updated Practice Location December 02, 2024

Registered at 11287 NW STATE ROAD 20, BRISTOL, FL 323213414 (Tel: 8506944420)

📍
Updated Business Mailing Address December 02, 2024

Registered at 11287 NW STATE ROAD 20, BRISTOL, FL 323213414 (Tel: 8506944420)

👤
Provider Name / Credentials Updated December 02, 2024

Recorded as ELYSE VAN WAGENEN, MA CCC SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 02, 2024

Speech-Language Pathologist (License #SLPCF000042 in DC)

📍
Updated Practice Location January 06, 2020

Registered at 2930 CAPITAL MEDICAL BLVD, TALLAHASSEE, FL 323084408 (Tel: 8506944420)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 06, 2020

Speech-Language Pathologist (License #SA17587 in FL)

NPI Profile Active May 23, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location May 23, 2019

Registered at 2600 DOUGLASS RD SE, WASHINGTON, DC, DC 20020 (Tel: 8506944429)

📍
Updated Business Mailing Address May 23, 2019

Registered at 2600 DOUGLASS RD SE, WASHINGTON, DC, DC 20020 (Tel: 8506944429)

👤
Provider Name / Credentials Updated May 23, 2019

Recorded as ELYSE WAHLQUIST

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 23, 2019

Speech-Language Pathologist (License #SLPCF000042 in DC)

🟢
Initial NPI Registration & Enumeration May 23, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1346807476
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 23, 2019
Last Update: December 02, 2024
Sole Proprietor: No

Mailing Address

11287 Nw State Road 20

Bristol, FL 323213414

Phone: 8506944420

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.