Individual provider Active NPI

Lauren Ettus

  • Speech-Language Pathologist
  • Monroe, NC
National Provider Identifier
1275397242
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30004252 Issued in NC
Practice address
402 Lane St
Monroe, NC 28112-5456
Phone
(704) 233-3428
NPI assigned
Feb 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA20470 FL
Speech-Language Pathologist 235Z00000X 30004252 NC Primary

Addresses

Primary practice location

402 Lane St
Monroe, NC 28112-5456

Mailing address

1605 Ambergate Dr
Waxhaw, NC 28173-6751
Phone (954) 415-9904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222000839 FL Practitioner - Qualified Speech Language Pathologist 2769826320 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30004252NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC CurrentSince Feb 12, 2024 Accepting new patients
Empowerme Rehabilitation Florida, LLC Speech-Language Pathologist CurrentSince Feb 12, 2024 Accepting new patients
Carolina Speech Connections, PLLC Speech-Language Pathologist CurrentSince Sep 8, 2025 Accepting new patients

Locations

6945 Carlisle Ct
Naples, FL 34109
Phone (239) 249-6877

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

402 Lane St
Monroe, NC 28112
Phone (704) 233-3428

Organizations & group practices 3

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": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1275397242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 AMBERGATE DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736751",
            "telephone_number": "954-415-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LANE ST",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281125456",
            "telephone_number": "704-233-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTUS",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20470",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30004252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.