Active NPI
Kassandra Nahyeli Carrillo
- Speech-Language Assistant
- Irving, TX
National Provider Identifier
1336916006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 42567
- Practice address
- 1431 Greenway Dr Ste 500
Irving, TX 75038-2444 - Phone
- (214) 467-9787
- Fax
- (214) 741-3655
- NPI assigned
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | 42567 | TX | Primary |
Addresses
Primary practice location
1431 Greenway Dr Ste 500
Irving, TX 75038-2444
Mailing address
9702 N Sam Houston Pkwy E Apt 1732
Humble, TX 77396-4556
Phone (956) 867-8920
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 |
|---|---|---|---|
| 42567 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Green Apple LLC | Current | Accepting new patients | |
| Therapy 2000 Inc | Current | Accepting new patients |
Locations
1431 Greenway Dr
Ste 500
Irving, TX 75038
Phone (214) 467-9787
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 and National Provider Directory roles.
-
- Home Health Agency
- Irving, TX
- NPI 1306170576
-
- Home Health Agency
- Irving, TX
- NPI 1265431977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1336916006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9702 N SAM HOUSTON PKWY E APT 1732",
"city": "HUMBLE",
"state": "TX",
"postal_code": "773964556",
"telephone_number": "956-867-8920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1431 GREENWAY DR STE 500",
"city": "IRVING",
"state": "TX",
"postal_code": "750382444",
"telephone_number": "214-467-9787",
"fax_number": "214-741-3655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRILLO",
"first_name": "KASSANDRA",
"middle_name": "NAHYELI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-12-04",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "TX",
"license": "42567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.