Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan Mezzanotte, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1114862471

Jordan Mezzanotte, MSCCC-SLP is a Qualified Speech Language Pathologist in Fairmont, West Virginia. Qualified in 2024, 2 years ago. Licensed in West Virginia.

Years since qualifying
2
Licensed in
WV
In the registry since
2026
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Practice location Address checks out

401 Guffey St
Fairmont, WV 26554-4029
Phone: (304) 363-2500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SLP-2631 (WV)

Record details

NPI number1114862471
Entity typeIndividual (Type 1)
GenderFemale
Credentials MSCCC-SLP
Sole proprietorNo
NPI enumeratedApril 22, 2026
Last updated in NPPESApril 22, 2026
Certification dateApril 22, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Fairmont