Carolynn Wise, M.S CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA11607 Issued in FL

Practice address

1451 SW 18TH Ave
Fort Lauderdale, FL 33312-4163

Phone

(570) 239-0396

NPI assigned

Jul 11, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Wise Speech Therapy LLC

  • Speech-Language Pathologist
  • Fort Lauderdale, FL
  • NPI 1376016733
  NPD (past) Authorized official

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1730477753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 SW 18TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333124163",
            "telephone_number": "570-239-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 SW 18TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333124163",
            "telephone_number": "570-239-0396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 SE 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Lauderdale",
            "state": "FL",
            "postal_code": "333013125",
            "country_code": "US",
            "telephone_number": "754-321-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "CAROLYNN",
        "credential": "M.S CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-11",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL009241",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisdom 3, LLC
• Marilyn Wisdom, LMHC
• Wise ABA LLC
• Wise Health Solutions
• Wise Speech Therapy LLC
• Jack Wise, DC
• Polly Wishon-Shah, AS,RT,R,M,CT,MR
• Anniki Yanique Witter, MD
• Madeline Louise Wnuk, PT, DPT, OCS
• Daniel Wohlberg

• Speech-Language Pathologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, 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 23, 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.