Individual provider Active NPI

Julie Clifford

  • Speech-Language Pathologist
  • Bangor, ME
National Provider Identifier
1427530278
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202009083 Issued in VA
Practice address
103 Texas Ave
Bangor, ME 04401-4324
Phone
(207) 947-4557
NPI assigned
Aug 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202009083 VA Primary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

103 Texas Ave
Bangor, ME 04401-4324

Mailing address

103 Texas Ave
Bangor, ME 04401-4324
Phone (207) 947-4557

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
2202009083VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553644800000",
    "number": "1427530278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 TEXAS AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014324",
            "telephone_number": "207-947-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 TEXAS AVE",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014324",
            "telephone_number": "207-947-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "JULIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2019-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202009083",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 27, 2019; 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.