Individual provider Active NPI

Danielle McGillicuddy, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Millinocket, ME
National Provider Identifier
1417295494
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP2306 Issued in ME
Practice address
191 Granite St
Millinocket, ME 04462-1300
Phone
(207) 723-6425
NPI assigned
Jan 25, 2013
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 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 SP2306 ME Primary

Addresses

Primary practice location

191 Granite St
Millinocket, ME 04462-1300

Mailing address

267 Massachusetts Ave
Millinocket, ME 04462-2237
Phone (207) 355-5073

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
SP2306MEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1417295494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267 MASSACHUSETTS AVE",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044622237",
            "telephone_number": "207-355-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 GRANITE ST",
            "city": "MILLINOCKET",
            "state": "ME",
            "postal_code": "044621300",
            "telephone_number": "207-723-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGILLICUDDY",
        "first_name": "DANIELLE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP2306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millinocket, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.