Katelyn Penna Berube, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2167 Issued in ME

Practice address

222 Auburn St
Suite 1G
Portland, ME 04103-6002

Phone

(207) 797-8255

Fax

(207) 797-5560

NPI assigned

Jul 6, 2011

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

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Hammond Associates Inc

  • Speech-Language Pathologist
  • Portland, ME
  • NPI 1457387904
  Medicare reassignment NPD

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1093002552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 AUBURN ST",
            "address_2": "SUITE 1G",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036002",
            "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",
            "address_2": "SUITE 1G",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041036002",
            "telephone_number": "207-797-8255",
            "fax_number": "207-797-5560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNA BERUBE",
        "first_name": "KATELYN",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan Pendexter, PNP
• Frances Pendleton, DDS
• Yordan Penev, MD
• Kathryn E. Penge, SP
• Anna Victoria Penkiunas
• Kevin Pennell, L.M.T.
• Nicholas D Pennell, FNP
• Keating W Pepper, DO
• Paloma Alejandra Peraza
• Gregory Benjamin Perchik, LCSW

• Speech-Language Pathologist in Portland, ME
• Providers in Portland, 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 Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.