Active NPI
Joan Marie Tardif, CCC-SLP
- Speech-Language Pathologist
- Ithaca, NY
National Provider Identifier
1104057512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 005979-1
- Practice address
- 106 Queen St
Ithaca, NY 14850-3746 - Phone
- (607) 273-3784
- NPI assigned
- Aug 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 | 005979-1 | NY | Primary |
Addresses
Primary practice location
106 Queen St
Ithaca, NY 14850-3746
Mailing address
106 Queen St
Ithaca, NY 14850-3746
Phone (607) 273-3784
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005979-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249257600000",
"number": "1104057512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 QUEEN ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148503746",
"telephone_number": "607-273-3784"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 QUEEN ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148503746",
"telephone_number": "607-273-3784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARDIF",
"first_name": "JOAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-03",
"last_updated": "2009-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "005979-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.