Individual provider Active NPI

Carol Lebaron, SLP

  • Speech-Language Pathologist
  • Harrisburg, NC
National Provider Identifier
1386000289
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1605151 Issued in NC
Practice address
4250 Main St
211
Harrisburg, NC 28075-7469
Phone
(888) 559-2818
Fax
(704) 731-0975
NPI assigned
Jan 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1605151 NC Primary

Addresses

Primary practice location

4250 Main St
211
Harrisburg, NC 28075-7469

Mailing address

4258 Highway 49 S
554
Harrisburg, NC 28075-0345
Phone (888) 559-2818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170502001057 NC Practitioner - Qualified Speech Language Pathologist 0547547432 Reassigns benefits to 1 organization
I20241112000222 SC Practitioner - Qualified Speech Language Pathologist 0547547432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

1973 Faison Ave
Fort Mill, SC 29708-8433
Phone (704) 285-8207

507 Wakefield Dr
Apt C
Charlotte, NC 28209-3148
Phone (704) 285-8207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6775SCMDMental Health Counselor
11928NCMDProfessional Counselor
1605151NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Collective Therapy Corp. Speech-Language Pathologist CurrentSince Nov 4, 2024 Accepting new patients
Orthocarolina PastSince Mar 2, 2017 Accepting new patients

Locations

8919 Park Rd
Charlotte, NC 28210
Phone (704) 384-1225

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.

NPI Registry JSON

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

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1386000289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4258 HIGHWAY 49 S",
            "address_2": "554",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280750345",
            "telephone_number": "888-559-2818",
            "fax_number": "704-731-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 MAIN ST",
            "address_2": "211",
            "city": "HARRISBURG",
            "state": "NC",
            "postal_code": "280757469",
            "telephone_number": "888-559-2818",
            "fax_number": "704-731-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBARON",
        "first_name": "CAROL",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "1605151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.