Marybeth Stout Allen, MS CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP618 Issued in ME

Practice address

5724 Dunn Hall
Room 336 University of Maine
Orono, ME 04469-5724

Phone

(207) 581-2403

Fax

(207) 581-2060

NPI assigned

Dec 6, 2006

Last updated

Feb 27, 2012By 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 identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Maine

  dba Conley Speech Language and Hearing Center

  • Speech-Language Pathologist
  • Orono, ME
  • NPI 1295921922
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1871652990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5724 DUNN HALL, ROOM 336",
            "address_2": "UNIVERSITY OF MAINE",
            "city": "ORONO",
            "state": "ME",
            "postal_code": "044695724",
            "telephone_number": "207-581-2403",
            "fax_number": "207-581-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5724 DUNN HALL",
            "address_2": "ROOM 336 UNIVERSITY OF MAINE",
            "city": "ORONO",
            "state": "ME",
            "postal_code": "044695724",
            "telephone_number": "207-581-2403",
            "fax_number": "207-581-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARYBETH",
        "middle_name": "STOUT",
        "name_prefix": "Mrs.",
        "credential": "MS CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "011088",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227430099",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227430000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA24460",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "038288",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Orono, ME
• Providers in Orono, ME by specialty
• Speech-Language Pathologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.