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ELYSE WAHLQUIST VAN WAGENEN MA CCC SLP
NPI 1346807476
Speech-Language Pathologist in Bristol, FL

Active since May 23, 2019
11287 NW STATE ROAD 20, BRISTOL, FL 32321(850) 694-4420 Get Directions Write a Review

NPPES record last updated: December 2, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 2, 2024, Jan 6, 2020, May 23, 2019 (3 updates tracked since 2019).

About Elyse Wahlquist Van Wagenen Ma Ccc Slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELYSE WAHLQUIST VAN WAGENEN MA CCC SLP (NPI 1346807476) is an individual speech-language pathologist provider in Bristol, Florida, licensed in Florida (SA17587) and active in the NPI registry since May 2019. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1346807476
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameELYSE WAHLQUIST VAN WAGENENCredential: MA CCC SLP
Location Address11287 NW STATE ROAD 20Bristol, FL 32321-3414
Mailing Address11287 Nw State Road 20Bristol, FL 32321-3414 · (850) 694-4420
Phone(850) 694-4420
Sole ProprietorNo
Enumeration DateMay 23, 2019
Last NPPES UpdateDecember 2, 20243 updates tracked since enumeration
NPPES CertifiedDecember 2, 2024
✔ NPI 1346807476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Licenses✔ Licensed in FL · SA17587✔ Licensed in DC · SLPCF000042
Definition
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.
11287 NW STATE ROAD 20, Bristol, FL 32321
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Secondary Practice Locations 2

Location 12930 Capital Medical BlvdTallahassee, FL 32308-4408 · Phone (850) 694-4420
Location 22600 Douglass Rd SEWashington, DC, DC 20020 · Phone (850) 694-4429

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHATTER PEDIATRIC THERAPY PLLC
Speech-Language Pathologist
11287 NW STATE ROAD 20
BRISTOL, FL 32321
Liberty County (850) 570-7178

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elyse Van Wagenen's NPI number?

The NPI number for Elyse Van Wagenen is 1346807476. It was assigned to this individual provider in the NPPES registry on May 23, 2019.

Where is Elyse Van Wagenen located?

Elyse Van Wagenen practices at 11287 NW State Road 20, Bristol, FL 32321. The listed phone number is (850) 694-4420.

What is Elyse Van Wagenen's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

When was this NPI record last updated?

The NPPES record for Elyse Van Wagenen was last updated on December 2, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.