Lara Gabrielle Ely

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

116742 Issued in TX

Practice address

2400 N Carroll Ave
Southlake, TX 76092-3105

Phone

(817) 949-8400

NPI assigned

Aug 10, 2022

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1093443715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 COZY PINE DR",
            "city": "NORTHLAKE",
            "state": "TX",
            "postal_code": "762262722",
            "telephone_number": "817-657-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N CARROLL AVE",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923105",
            "telephone_number": "817-949-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "LARA",
        "middle_name": "GABRIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-10",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "116742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elixir 360 Health
• Cassie Ellinger
• Jennifer D Elliott, M.S., L.P.C.
• Shelley Kay Gore Elliott, MS, LPC
• Allison Ellis, LMFT-ASSOCIATE
• Obinna C. Emechebe-Kennedy, M.D., PHARM.D.
• Emergency Care USA
• Emergency Centers of Texas, LTD
• Sarah Enchautegui, PMHNP-BC
• Encompass Therapy & Counseling, PC

• Speech-Language Pathologist in Southlake, TX
• Providers in Southlake, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.