NPIMap

Individual provider Active NPI

Carly Maddox Lawhead, MA

  • Speech-Language Pathologist
  • Bellevue, WA
National Provider Identifier
1760616700
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL 60024124 Issued in WA
Practice address
2445 140TH Ave NE
Suite B105
Bellevue, WA 98005-1879
Phone
(425) 644-6328
Fax
(425) 644-6295
NPI assigned
May 5, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X LL 60024124 WA Primary

Addresses

Primary practice location

2445 140TH Ave NE
Suite B105
Bellevue, WA 98005-1879

Mailing address

2445 140TH Ave NE
Suite B105
Bellevue, WA 98005-1879
Phone (425) 644-6328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LL 60024124WAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mosaic Rehabilitation, Inc Past Accepting new patients
Mosaic Rehabilitation Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1760616700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 140TH AVE NE",
            "address_2": "SUITE B105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051879",
            "telephone_number": "425-644-6328",
            "fax_number": "425-644-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 140TH AVE NE",
            "address_2": "SUITE B105",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051879",
            "telephone_number": "425-644-6328",
            "fax_number": "425-644-6295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWHEAD",
        "first_name": "CARLY",
        "middle_name": "MADDOX",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL 60024124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.