Carly Clark Robinson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6628 Issued in SC

Practice address

133 Broadbent Way
Anderson, SC 29625-1521

Phone

(888) 510-6369

NPI assigned

Sep 6, 2017

Last updated

Jan 27, 2020By 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 2

Addresses

Other names 1

• Carly Jamison Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1790203073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 BROADBENT WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296251521",
            "telephone_number": "888-510-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 BROADBENT WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296251521",
            "telephone_number": "888-510-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "CARLY",
        "middle_name": "CLARK",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-06",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "CLARK",
            "middle_name": "JAMISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith A. Robertson, P.A.
• Nefertiti Robertson
• Alexandria Robinson
• Alexis Kenyatta Robinson, NP
• Candace Robinson
• Deloris Robinson
• Thomas A Robinson Jr., HAS
• Mason H Rockwell, PT
• Rocky River Therapy LLC
• Lisa Rodgers, PT, DPT

• Speech-Language Pathologist in Anderson, SC
• Providers in Anderson, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; 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.