Individual provider Active NPI

Mollie Carlson

  • Speech-Language Pathologist
  • Huntersville, NC
National Provider Identifier
1043662588
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11471 Issued in NC
Practice address
320 Seagle St
Huntersville, NC 28078-4334
Phone
(704) 752-1616
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8107 SC
Speech-Language Pathologist 235Z00000X 11471 NC Primary
Speech-Language Pathologist 235Z00000X SLP.0003628 CO

Addresses

Primary practice location

320 Seagle St
Huntersville, NC 28078-4334

Mailing address

320 Seagle St Ste 9
Huntersville, NC 28078-4337
Phone (704) 752-1616

Other practice location 1

1612 Ebenezer Rd Ste 101
Rock Hill, SC 29732-3862
Phone (803) 329-9500

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

LicenseStateTypeSpecialty
11471NCMDCounselor
SLP.0003628COMDSpeech-Language Pathologist
8107SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Queen City Therapy, PLLC Speech-Language Pathologist PastSince Aug 6, 2023 Accepting new patients
Pediatric Hands on Therapy, PC Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1043662588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SEAGLE ST STE 9",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784337",
            "telephone_number": "704-752-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SEAGLE ST",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784334",
            "telephone_number": "704-752-1616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1612 Ebenezer Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rock Hill",
            "state": "SC",
            "postal_code": "297323862",
            "country_code": "US",
            "telephone_number": "803-329-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MOLLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8107",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11471",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0003628",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntersville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.