Carly Cearley

Individual provider Active NPI Speech-Language Pathologist · Ingram, TX

NPI 1417864612 · NPPES record last updated Aug 25, 2026

Key facts

NPI
1417864612
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
120356 (TX)
Practice address
111 Lakebridge TRL
Ingram, TX 78025-5576
Phone
(830) 739-6366
NPI assigned
Aug 25, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 120356 TX Yes

Addresses

Primary practice location

111 Lakebridge TRL
Ingram, TX 78025-5576

Mailing address

111 Lakebridge TRL
Ingram, TX 78025-5576
Phone (830) 739-6366

Other providers in Ingram, TX

All providers in Ingram, TX · Speech-Language Pathologist in Texas

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2026. Information in NPPES is self-reported and not verified by CMS.
  • NUCC Health Care Provider Taxonomy: specialty names.

Verify at the official NPI Registry.