Individual provider Active NPI

Carly Clegg Nelson

  • Behavior Analyst
  • Beaufort, SC
National Provider Identifier
1255030425
Registry record updated Sep 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-25-79181 Issued in SC
Practice address
1105 Middleton St Unit B
Beaufort, SC 29902-5611
Phone
(843) 379-3444
Fax
(843) 379-3449
NPI assigned
Feb 27, 2023
Last updated
Sep 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-25-79181 SC Primary

Addresses

Primary practice location

1105 Middleton St Unit B
Beaufort, SC 29902-5611

Mailing address

1105B Middleton St Ste B
Beaufort, SC 29902-5358
Phone (843) 379-3444

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boost Behavioral Services LLC Behavior Analyst CurrentSince Mar 5, 2023 Accepting new patients
Carolina Cognitive Behavior Analyst PastSince Oct 1, 2023 Accepting new patients

Locations

14B Marshellen Dr
Beaufort, SC 29902
Phone (843) 400-4581

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1255030425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105B MIDDLETON ST STE B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025358",
            "telephone_number": "843-379-3444",
            "fax_number": "843-379-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MIDDLETON ST UNIT B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025611",
            "telephone_number": "843-379-3444",
            "fax_number": "843-379-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CARLY",
        "middle_name": "CLEGG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "SC",
            "license": "1-25-79181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 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.

Verify at the official NPI Registry.