Individual provider Active NPI

Christina Marie Carson, MS CCC-SLP, MA BCBA

  • Speech-Language Pathologist
  • Port Charlotte, FL
National Provider Identifier
1366636078
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8944 Issued in FL
Practice address
460 Dalton Blvd
Port Charlotte, FL 33952-8360
Phone
(321) 732-0368
NPI assigned
Sep 5, 2007
Last updated
Jul 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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 SA8944 FL Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

460 Dalton Blvd
Port Charlotte, FL 33952-8360

Mailing address

150 Avenue B SE
Winter Haven, FL 33880-3037

Other identifiers 1

IdentifierTypeStateIssuer
891244100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191018001788 FL Practitioner - Qualified Speech Language Pathologist 5890026025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dah Therapies LLCGroup PAC ID 5395078968, 25 clinicians

Practice addresses (Care Compare)

6870 Alister Way
Fort Myers, FL 33912-4535
Phone (239) 676-2080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Master of Science

State licenses

LicenseStateTypeSpecialty
SA8944FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope & Associates, LLC Speech-Language Pathologist CurrentSince Mar 11, 2025 Accepting new patients
Love and Co Therapeutic Interventions,LLC Speech-Language Pathologist CurrentSince Jul 14, 2019 Accepting new patients
Hope & Associates, LLC Behavior Analyst CurrentSince Mar 11, 2025 Accepting new patients
Love & Behavior Therapy LLC Behavior Analyst PastSince Jun 12, 2022 Accepting new patients
Love and Co Therapeutic Interventions,LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 6

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": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1366636078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AVENUE B SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338803037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 DALTON BLVD",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339528360",
            "telephone_number": "321-732-0368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "MS CCC-SLP, MA BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8944",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891244100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.