Tanya Mae Thibeau, MA CCC-SLP

Primary specialty

Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X

License

SP1099 Issued in ME

Practice address

285 Benton Ave
Winslow, ME 04901

Phone

(207) 872-1967

NPI assigned

Oct 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aos 92

  • Speech-Language Pathologist
  • Winslow, ME
  • NPI 1760798953
  NPD (past) Authorized official

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1346540523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 DEAN STREET",
            "city": "WINSLOW",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-859-2313",
            "fax_number": "207-859-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 BENTON AVE",
            "city": "WINSLOW",
            "state": "ME",
            "postal_code": "04901",
            "telephone_number": "207-872-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBEAU",
        "first_name": "TANYA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "ME",
            "license": "SP1099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsha Spector, OT
• Isaiah Robert Stephan, D.C.
• Joshua Stetson, ATC, CSCS
• Lawrence Paul Strohmeyer, DO
• Shoaib Imtiaz Syed, RPH
• Town of Winslow
• Town of Winslow
• Town of Winslow
• Town of Winslow
• Walgreen Eastern Co Inc

• Speech/Language/Hearing Specialist/Technologist in Winslow, ME
• Providers in Winslow, ME by specialty
• Speech/Language/Hearing Specialist/Technologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.