Individual provider Active NPI

Jacqueline R Delong, MA CF-SLP

  • Speech-Language Pathologist
  • Portland, ME
National Provider Identifier
1033766563
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ST2995 Issued in ME
Practice address
222 Auburn St
Portland, ME 04103-6002
Phone
(207) 797-8255
Fax
(207) 797-5560
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X ST2995 ME Primary

Addresses

Primary practice location

222 Auburn St
Portland, ME 04103-6002

Mailing address

222 Auburn St Ste 1G
Portland, ME 04103-6012
Phone (207) 797-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
ST2995MEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hammond Associates Inc Speech-Language Pathologist PastSince Aug 25, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1033766563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST STE 1G",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036012",
            "telephone_number": "207-797-8255",
            "fax_number": "207-797-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036002",
            "telephone_number": "207-797-8255",
            "fax_number": "207-797-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELONG",
        "first_name": "JACQUELINE",
        "middle_name": "R",
        "credential": "MA CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST2995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.