Yelena Zoya Carlisle, M.S. CCC-SLP, CLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP006410 Issued in GA

Practice address

4811 Village SQ NW
Acworth, GA 30102-3464

Phone

(404) 665-7804

NPI assigned

Oct 31, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

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.

• Gift of Gab Speech Therapy Services

  • Speech-Language Pathologist
  • Acworth, GA
  • NPI 1023743796
  NPD Authorized official

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1679659650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4811 VILLAGE SQ NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301023464",
            "telephone_number": "404-665-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4811 VILLAGE SQ NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301023464",
            "telephone_number": "404-665-7804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLISLE",
        "first_name": "YELENA",
        "middle_name": "ZOYA",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP006410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "850584527A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85058427A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carissa Eve Campos, D.D.S.
• Candid Hearts Healthcare Services LLC
• John Michael Caraway, DPT
• Care Assurance LLC
• Care Intl LLC
• Jennifer Gayle Carruth, NP
• Ahniya Nycole Carson
• Karen Casadaban, SLP
• Abigayle Casey
• Mariuche Casole, LCSW

• Speech-Language Pathologist in Acworth, GA
• Providers in Acworth, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.