Jamie Lynn Rabideau, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

018169 Issued in NY

Practice address

5572 Route 11
Ellenburg, NY 12933

Phone

(518) 594-7060

NPI assigned

Nov 5, 2008

Last updated

Nov 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jamie Lynn Harrison Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1740434646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 ROUTE 22",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129014914",
            "telephone_number": "518-572-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5572 ROUTE 11",
            "city": "ELLENBURG",
            "state": "NY",
            "postal_code": "12933",
            "telephone_number": "518-594-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABIDEAU",
        "first_name": "JAMIE",
        "middle_name": "LYNN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-05",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "018169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "HARRISON",
            "middle_name": "LYNN",
            "credential": "M.A., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa L McDonald, FNP-C
• Northwestern Family Medical Ctr

• Speech-Language Pathologist in Ellenburg, NY
• Providers in Ellenburg, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.