Carly Morgan Traversa

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SZ9579 Issued in FL

Practice address

1239 Belvedere Ave
Jacksonville, FL 32205-7940

Phone

(321) 795-7829

NPI assigned

Nov 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Christy Miller LLC

  • Occupational Therapist
  • Yulee, FL
  • NPI 1619583770

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1605484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1265035026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 BELVEDERE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057940",
            "telephone_number": "321-795-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1239 BELVEDERE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322057940",
            "telephone_number": "321-795-7829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVERSA",
        "first_name": "CARLY",
        "middle_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-16",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2909",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0005601",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ9579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trauma Healing Center, LLC
• Christopher Trautman, MD
• Stefano Travaglini, M.D.
• Alejandro I Traveria, MD
• Paul M Travers, MD
• Travis Nolan
• Harrison James Travis, MD
• Robert F Travis Jr., D. C.
• Kelly Traylor
• Stanley Eugene Traylor III

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.