Active NPI
Mary Dolores Carlson, M.ED
- Speech-Language Pathologist
- Lawrence, MA
National Provider Identifier
1407142169
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2829
- Practice address
- 360 Merrimack St
Lawrence, MA 01843-1740 - Phone
- (978) 552-4605
- Fax
- (978) 552-4394
- NPI assigned
- Jun 21, 2011
- Last updated
- Jun 21, 2011
- 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 Pathologist | 235Z00000X | 2829 | MA | Primary |
Addresses
Primary practice location
360 Merrimack St
Lawrence, MA 01843-1740
Mailing address
360 Merrimack St
Lawrence, MA 01843-1740
Phone (978) 552-4605
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)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2829 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1407142169",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 MERRIMACK ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431740",
"telephone_number": "978-552-4605",
"fax_number": "978-552-4394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 MERRIMACK ST",
"city": "LAWRENCE",
"state": "MA",
"postal_code": "018431740",
"telephone_number": "978-552-4605",
"fax_number": "978-552-4394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "MARY",
"middle_name": "DOLORES",
"name_prefix": "Mrs.",
"credential": "M.ED",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "2829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.