Mary Carbonneau, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1901 Issued in NH

Practice address

38 McElwain St
Merrimack, NH 03054-3663

Phone

(603) 424-6204

Fax

(603) 424-6230

NPI assigned

Sep 22, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Boothby Therapy Services, LLC

  • Occupational Therapist
  • Laconia, NH
  • NPI 1770797094
  NPD (past)

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1811503121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOOTHBY THERAPY SERVICES",
            "address_2": "806 NORTH MAIN STREET",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "03246",
            "telephone_number": "603-524-9090",
            "fax_number": "603-524-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 MCELWAIN ST",
            "city": "MERRIMACK",
            "state": "NH",
            "postal_code": "030543663",
            "telephone_number": "603-424-6204",
            "fax_number": "603-424-6230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 Madeline Bennett Ln",
            "address_purpose": "LOCATION",
            "city": "Merrimack",
            "state": "NH",
            "postal_code": "030542954",
            "country_code": "US",
            "telephone_number": "603-424-6289",
            "fax_number": "603-423-1109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBONNEAU",
        "first_name": "MARY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-22",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NH",
            "license": "1901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Brooks
• Amy S Brumfield, MD
• Lucille Huffard Byno, PH.D.
• Catherine G Cagino, DDS
• Marie Carbonneau, OT
• Joseph A Cardamone, DDS
• Care Plus Emergency Ambulance Service, Inc
• Careplus Seacoast
• Thomas J. Carozza
• Carissa Carrier, M.S.ED, CCC-SLP

• Speech-Language Pathologist in Merrimack, NH
• Providers in Merrimack, NH by specialty
• Speech-Language Pathologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.