Katharine J Disalvatore Fortin, MA

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP1742 Issued in ME

Practice address

700 Mount Hope Ave Ste 320
Bangor, ME 04401-5680

Phone

(207) 941-2952

Fax

(207) 941-2955

NPI assigned

Nov 15, 2006

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 1

Other names 1

• Katharine Jeanne Lessard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1992877765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE STE 320",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015680",
            "telephone_number": "207-941-2952",
            "fax_number": "207-941-2955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MOUNT HOPE AVE STE 320",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015680",
            "telephone_number": "207-941-2952",
            "fax_number": "207-941-2955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTIN",
        "first_name": "KATHARINE",
        "middle_name": "J DISALVATORE",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ME",
            "license": "SP1742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251820099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHARINE",
            "last_name": "LESSARD",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Renee Michelle Ford, PHARMD
• Samuel Richard Ford
• Lori A Forest, N.D.
• Kathleen Forti-Gallant, FNP
• Kathleen M Fortier, LCPC
• Lisa B Foss, RN
• Suzanne Victoria Fougere, LCPC-C
• Chad Michael Fournier
• Alicia Muriel Fowle, M.A.,CCC-SLP
• Rebecca Fowler, RN

• Speech-Language Pathologist in Bangor, ME
• Providers in Bangor, 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 Jan 11, 2017; 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.