Kayla Marie Carmack, MS.,CCC,SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP11316 Issued in AZ

Practice address

7775 W Orangewood Ave
Glendale, AZ 85303-1502

Phone

(623) 237-4000

NPI assigned

Jul 30, 2018

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

Practice roles

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.

• Glendale Elementary School District #40

  • Local Education Agency (LEA)
  • Glendale, AZ
  • NPI 1811197916
  NPD (past)

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1659859064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853011893",
            "telephone_number": "623-237-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7775 W ORANGEWOOD AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853031502",
            "telephone_number": "623-237-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMACK",
        "first_name": "KAYLA",
        "middle_name": "MARIE",
        "credential": "MS.,CCC,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP11316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Larissa Carnett
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• Melanie Ann Caron-Vlasak, LCSW

• Speech-Language Pathologist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.