Individual provider Active NPI

Carly Elizabeth Mattingly, M.S., CCC-SLP

  • Speech-Language Pathologist
  • North Charleston, SC
National Provider Identifier
1437964095
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8495 Issued in SC
Practice address
4969 Chateau Ave
North Charleston, SC 29405-4808
Phone
(270) 321-0941
NPI assigned
Feb 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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 8495 SC Primary

Addresses

Primary practice location

4969 Chateau Ave
North Charleston, SC 29405-4808

Mailing address

4969 Chateau Ave
North Charleston, SC 29405-4808
Phone (270) 321-0941

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8495SCMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1739232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1437964095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4969 CHATEAU AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054808",
            "telephone_number": "270-321-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4969 CHATEAU AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054808",
            "telephone_number": "270-321-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTINGLY",
        "first_name": "CARLY",
        "middle_name": "ELIZABETH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-11",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.