Carly Grace Nelson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.14561 Issued in OH

Practice address

2772 Lutz Ave
Mansfield, OH 44903-9658

Phone

(440) 537-2429

NPI assigned

Aug 20, 2020

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

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.

• Prosperity Therapy LLC

  • Speech-Language Pathologist
  • Mansfield, OH
  • NPI 1578224432
  NPD Authorized official

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1669084646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 LUTZ AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449039658",
            "telephone_number": "440-537-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 LUTZ AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449039658",
            "telephone_number": "440-537-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "CARLY",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.14561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karla Kowalski Naumoff, LISW-S
• Kirstie Naumoff, LISW
• Bairanje R Nayak, PHD OD
• Rebecca J Nduaguba, D.O.
• Kelly Lynn Nell, NP-C
• Dayna Lynn Nelson
• Miriam Nelson
• Robert D Nelson
• Jasmine Neuman, LSW
• Leeann Neumann, STNA

• Speech-Language Pathologist in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.