Active NPI
Bethann Deleo, MA, CCC-SLP
- Speech-Language Pathologist
- Andover, MA
National Provider Identifier
1386119956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6171
- Practice address
- 18 Wabanaki Way
Andover, MA 01810-5513 - Phone
- (781) 249-7070
- NPI assigned
- Oct 9, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6171 | MA | Primary |
Addresses
Primary practice location
18 Wabanaki Way
Andover, MA 01810-5513
Mailing address
18 Wabanaki Way
Andover, MA 01810-5513
Phone (781) 249-7070
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6171 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539043200000",
"number": "1386119956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 WABANAKI WAY",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018105513",
"telephone_number": "781-249-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 WABANAKI WAY",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018105513",
"telephone_number": "781-249-7070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELEO",
"first_name": "BETHANN",
"credential": "MA, CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-09",
"last_updated": "2018-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "6171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.