1225888902 NPI number — CHICKADEE CHATTER SPEECH THERAPY LLC

Table of content: (NPI 1225888902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225888902 NPI number — CHICKADEE CHATTER SPEECH THERAPY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHICKADEE CHATTER SPEECH THERAPY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225888902
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 GARLAND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHAPLEIGH
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04076-3511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-281-7690
Provider Business Mailing Address Fax Number:
207-910-6547

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
460 MAIN ST STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGVALE
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04083-1874
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-281-7690
Provider Business Practice Location Address Fax Number:
207-910-6547
Provider Enumeration Date:
03/25/2024

Additional Information

Authorized Official

Authorized Official Last Name:
RACKLIFF
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
CARAMIHALIS
Authorized Official Title or Position:
SPEECH-LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
207-206-5220

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com