Tareyn Prince

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

ST3066 Issued in ME

Practice address

357 Tuttle Rd
Cumberland Center, ME 04021-3625

Phone

(207) 829-4800

NPI assigned

Feb 28, 2020

Last updated

Nov 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Msad #51

  • Local Education Agency (LEA)
  • Cumberland, ME
  • NPI 1578778486
  NPD (past)

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1043844079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 LITTLE RIVER DR",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040382553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 TUTTLE RD",
            "city": "CUMBERLAND CENTER",
            "state": "ME",
            "postal_code": "040213625",
            "telephone_number": "207-829-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Frances Bell Dr",
            "address_purpose": "LOCATION",
            "city": "Bridgton",
            "state": "ME",
            "postal_code": "040091278",
            "country_code": "US",
            "telephone_number": "207-647-5675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRINCE",
        "first_name": "TAREYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST3066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013120898",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "BRIDGTON",
            "affiliation": "N",
            "address_1": "14 Frances Bell Dr",
            "city": "Bridgton",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040091278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Cumberland Center, ME
• Providers in Cumberland Center, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.