Individual provider Active NPI

Collette Therese Dibello, CF-SLP

  • Speech-Language Pathologist
  • Brewer, ME
National Provider Identifier
1306712641
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ST4484 Issued in ME
Practice address
797 Wilson St Ste 2
Brewer, ME 04412-1003
Phone
(207) 947-8493
NPI assigned
Oct 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X ST4484 ME Primary

Addresses

Primary practice location

797 Wilson St Ste 2
Brewer, ME 04412-1003

Mailing address

797 Wilson St Ste 2
Brewer, ME 04412-1003
Phone (207) 947-8493

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

LicenseStateTypeSpecialty
ST4484MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1306712641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "797 WILSON ST STE 2",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121003",
            "telephone_number": "207-947-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "797 WILSON ST STE 2",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121003",
            "telephone_number": "207-947-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLO",
        "first_name": "COLLETTE",
        "middle_name": "THERESE",
        "credential": "CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST4484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewer, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2025; 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.