Mary Elizabeth Carlson, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA16928 Issued in FL

Practice address

9803 Old Saint Augustine Rd Ste 8
Jacksonville, FL 32257-8845

Phone

(904) 880-9001

NPI assigned

May 3, 2019

Last updated

Oct 26, 2023By 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

Other names 1

• Mary Elizabeth Troutman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1710542832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7054 EMSLEY CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322588544",
            "telephone_number": "904-805-3092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9803 OLD SAINT AUGUSTINE RD STE 8",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322578845",
            "telephone_number": "904-880-9001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7054 Emsley Cir",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322588544",
            "country_code": "US",
            "telephone_number": "904-805-3092",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3311 Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322073704",
            "country_code": "US",
            "telephone_number": "904-396-1462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA16928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "TROUTMAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Nylas Carlson, D.O.
• Dawn Carlson, PH.D.
• Jeremiah Wesley Carlson
• Jeremy Carlson
• Joanne L Carlson, MD
• Melanie Wesner Carlson
• Richard D Carlson, DMD
• Robert Michael Carlson, MD
• Justin Carmel, D.P.T.
• Venessa Carmel

• Speech-Language Pathologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.