Portland Pediatric Speech Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP2317 Issued in ME

Legal business name

PORTLAND PEDIATRIC SPEECH THERAPY

Practice address

341 Highland Ave # 1
South Portland, ME 04106-4510

Phone

(301) 802-8342

NPI assigned

Dec 5, 2016

Organization subpart

No

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

Authorized official

Name

Susan Bahadori, M.A., CCC-SLPNPI 1013451475

Title

Speech-Language Pathologist

Phone

(301) 802-8342

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Bahadori, M.A., CCC-SLP

  • Speech-Language Pathologist
  • South Portland, ME
  • NPI 1013451475
  NPD (past) Authorized official

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

{
    "created_epoch": "1480896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1164966529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 HIGHLAND AVE # 1",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064510",
            "telephone_number": "301-802-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 HIGHLAND AVE # 1",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064510",
            "telephone_number": "301-802-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND PEDIATRIC SPEECH THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-05",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "BAHADORI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "301-802-8342",
        "authorized_official_credential": "M.A., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra R Porter
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Orthopaedic Foot and Ankle Center
• Positive Residential Care, LLC
• Jesse R Potter, ATC, LAT
• Debra Pow, LMSWCC
• Henry Powell, MSOTR/L
• John Preston Powell, MD

• Speech-Language Pathologist in South Portland, ME
• Providers in South 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 Dec 5, 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.

Verify at the official NPI Registry.