Individual provider Active NPI

Carmen R Tucker-Richardson, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Towson, MD
National Provider Identifier
1801915079
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
05266 Issued in MD
Practice address
1 Olympic PL
Towson, MD 21204-4104
Phone
(443) 579-4757
NPI assigned
Mar 28, 2007
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 05266 MD Primary

Addresses

Primary practice location

1 Olympic PL
Towson, MD 21204-4104

Mailing address

PO Box 43893
Nottingham, MD 21236-0893
Phone (443) 579-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131217000497 MD Practitioner - Qualified Speech Language Pathologist 0749417822 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9307 Innsbrook Way
Baltimore, MD 21236-5005
Phone (443) 579-4757

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
05266MDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Therapy, LLC CurrentSince Mar 1, 2019 Accepting new patients
Integrated Healthcare Solutions CurrentSince Jun 1, 2025 Accepting new patients
State of Maryland Central Payroll Bureau CurrentSince Feb 1, 2013 Accepting new patients
Primary NP Associates CurrentSince Jun 1, 2025 Accepting new patients
Comptroller of Maryland Central Payroll Bureau CurrentSince Feb 1, 2013 Accepting new patients

Locations

110 Painters Mill Rd
Ste 206
Owings Mills, MD 21117
Phone (410) 356-4680

1 Olympic Pl
Ste 200
Towson, MD 21204
Phone (410) 704-3095

8000 York Rd
Towson, MD 21252
Phone (410) 704-2000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1801915079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43893",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212360893",
            "telephone_number": "443-579-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OLYMPIC PL",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212044104",
            "telephone_number": "443-579-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER-RICHARDSON",
        "first_name": "CARMEN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.