Active NPI
Beth-Anne Kanecke, MS, CCC-SLP, TSSLD
- Speech-Language Pathologist
- Portland, ME
National Provider Identifier
1093022436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 020276-1
- Practice address
- 68 Bishop St
Unit 1, Room 5
Portland, ME 04103-2681 - Phone
- (646) 924-5111
- NPI assigned
- Sep 7, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 020276-1 | NY | Primary |
Addresses
Primary practice location
68 Bishop St
Unit 1, Room 5
Portland, ME 04103-2681
Mailing address
68 Bishop St
Unit 1, Room 5
Portland, ME 04103-2681
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 020276 | NY | MD | Clinical Neuropsychologist |
| 020276-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1093022436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 BISHOP ST",
"address_2": "UNIT 1, ROOM 5",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 BISHOP ST",
"address_2": "UNIT 1, ROOM 5",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041032681",
"telephone_number": "646-924-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANECKE",
"first_name": "BETH-ANNE",
"credential": "MS, CCC-SLP, TSSLD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-07",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "020276-1",
"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 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.