Active NPI
Jeanne Civiello
- Speech-Language Pathologist
- Portsmouth, NH
National Provider Identifier
1740922889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1079
- Practice address
- 66 Suzanne Dr
Portsmouth, NH 03801-5956 - Phone
- (978) 337-4894
- NPI assigned
- Apr 9, 2022
- 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 | 1079 | NH | Primary |
Addresses
Primary practice location
66 Suzanne Dr
Portsmouth, NH 03801-5956
Mailing address
66 Suzanne Dr
Portsmouth, NH 03801-5956
Phone (978) 337-4894
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1079 | NH | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649462400000",
"number": "1740922889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 SUZANNE DR",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015956",
"telephone_number": "978-337-4894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "66 SUZANNE DR",
"city": "PORTSMOUTH",
"state": "NH",
"postal_code": "038015956",
"telephone_number": "978-337-4894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIVIELLO",
"first_name": "JEANNE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-09",
"last_updated": "2022-04-09",
"certification_date": "2022-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NH",
"license": "1079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.