Individual provider Active NPI

Marnie Suzanne Millington, MS CCC SLP

  • Speech-Language Pathologist
  • Needham, MA
National Provider Identifier
1295906279
Registry record updated Mar 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4933 Issued in MA
Practice address
150 West Street
Needham, MA 02494-1319
Phone
(781) 726-6209
Fax
(781) 726-6212
NPI assigned
Mar 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 4933 MA Primary
Speech-Language Pathologist 235Z00000X 12012226

Addresses

Primary practice location

150 West Street
Needham, MA 02494-1319

Mailing address

150 West Street
Needham, MA 02494-1319
Phone (781) 726-6209

Other identifiers 1

IdentifierTypeStateIssuer
SP0091OtherMABLUE CROSS BLUE SHIELD

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4933MAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205798400000",
    "number": "1295906279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 WEST STREET",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941319",
            "telephone_number": "781-726-6209",
            "fax_number": "781-726-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 WEST STREET",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024941319",
            "telephone_number": "781-726-6209",
            "fax_number": "781-726-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLINGTON",
        "first_name": "MARNIE",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "4933",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "12012226",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "SP0091",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.