Active NPI
Lydia Adelle Bravo-Taylor
- Speech-Language Pathologist
- Cary, NC
National Provider Identifier
1134065337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 30003706
- Practice address
- 109 Fountain Brook Cir Ste a
Cary, NC 27511-3370 - Phone
- (919) 238-9088
- Fax
- (919) 375-2538
- NPI assigned
- Apr 28, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 30003706 | NC | Primary |
Addresses
Primary practice location
109 Fountain Brook Cir Ste a
Cary, NC 27511-3370
Mailing address
10017 Liana LN
Raleigh, NC 27613-5905
Phone (919) 357-8961
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
| License | State | Type | Specialty |
|---|---|---|---|
| 30003706 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Tree Services PLLC | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Cary, NC
- NPI 1720912488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1134065337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10017 LIANA LN",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276135905",
"telephone_number": "919-357-8961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 FOUNTAIN BROOK CIR STE A",
"city": "CARY",
"state": "NC",
"postal_code": "275113370",
"telephone_number": "919-238-9088",
"fax_number": "919-375-2538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO-TAYLOR",
"first_name": "LYDIA",
"middle_name": "ADELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-28",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "30003706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.