Mary Caroline Evangelisti

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5545 Issued in MS

Practice address

3964 Goodman Rd E Ste 105
Southaven, MS 38672-8711

Phone

(662) 932-4625

Fax

(662) 932-4626

NPI assigned

Jun 25, 2026

Last updated

Jun 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1782345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1609792431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2188 DOGWOOD OAKS DR",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381395303",
            "telephone_number": "901-232-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3964 GOODMAN RD E STE 105",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386728711",
            "telephone_number": "662-932-4625",
            "fax_number": "662-932-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTI",
        "first_name": "MARY",
        "middle_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-25",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "5545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Southaven, MS
• Providers in Southaven, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; 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.