Active NPI
Tracy Lynne Demarino, MS,CCC/SLP
- Speech-Language Pathologist
- Westbrook, ME
National Provider Identifier
1629304530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP1173
- Practice address
- 300 Spring St
Westbrook, ME 04092-3915 - Phone
- (207) 856-1240
- NPI assigned
- Oct 28, 2009
- Sex
- Female
- Sole proprietor
- No
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 | SP1173 | ME | Primary |
Addresses
Primary practice location
300 Spring St
Westbrook, ME 04092-3915
Mailing address
300 Spring St
Westbrook, ME 04092-3915
Phone (207) 856-1240
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 432470100 | Medicaid | ME |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP1173 | ME | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1629304530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SPRING ST",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923915",
"telephone_number": "207-856-1240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SPRING ST",
"city": "WESTBROOK",
"state": "ME",
"postal_code": "040923915",
"telephone_number": "207-856-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEMARINO",
"first_name": "TRACY",
"middle_name": "LYNNE",
"credential": "MS,CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-28",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ME",
"license": "SP1173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "432470100",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westbrook, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.