Marybeth Davis Pride, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1303 Issued in ME

Practice address

78 Cedar St
Rockland, ME 04841-3146

Phone

(207) 208-7233

NPI assigned

Aug 23, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Cedar Street Preschool Inc

  • Speech-Language Pathologist
  • Rockland, ME
  • NPI 1154606671
  NPD (past) Authorized official

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282521600000",
    "number": "1982910311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 CEDAR ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048413146",
            "telephone_number": "207-208-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 CEDAR ST",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048413146",
            "telephone_number": "207-208-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDE",
        "first_name": "MARYBETH",
        "middle_name": "DAVIS",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2010-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "263810000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Pickering, RN
• Lucinda Jane Pooler, LMSW
• Posabilities Inc
• Tia Marie Poulin, LADC, CCS
• Samuel William Powell, DPT
• Roger Herman Quehl, LMSW-CC
• Shannon Lynn Rainey, CCPC
• Abigale Razo, LCSW
• Michael W Reeves, LCSW
• Regional School Unit 13

• Speech-Language Pathologist in Rockland, ME
• Providers in Rockland, 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 Aug 23, 2010; 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.