Individual provider Active NPI

Jessica A Fink, SLP

  • Speech-Language Pathologist
  • Bangor, ME
National Provider Identifier
1356062822
Registry record updated Sep 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
ST3723 Issued in ME
Practice address
304 Garland St
Bangor, ME 04401-5543
Phone
(207) 941-6230
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2022

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 ST3723 ME Primary

Addresses

Primary practice location

304 Garland St
Bangor, ME 04401-5543

Mailing address

PO Box 81
Hampden, ME 04444-0081

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
ST3723MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662336000000",
    "number": "1356062822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044440081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 GARLAND ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015543",
            "telephone_number": "207-941-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINK",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-09-05",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "ST3723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2022; 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.