Tara Carlson, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL60813836 Issued in WA

Practice address

123 W Cascade Way
Spokane, WA 99208-6017

Phone

(509) 624-3115

NPI assigned

Jul 21, 2016

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 identifiers 1

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.

• Periwinkle Children'S Therapy

  • Contractor
  • Hayden, ID
  • NPI 1184972184
  NPD (past)
• Periwinkle Children'S Therapy

  • Community/Behavioral Health Agency
  • Coeur D Alene, ID
  • NPI 1598211856
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1942653290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 W CASCADE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086017",
            "telephone_number": "509-624-3115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 W CASCADE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992086017",
            "telephone_number": "509-624-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "TARA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-3021",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60813836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH LANGUAGE PATHOLOGY LICENSE",
            "identifier": "LL60813836",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Harlan Carlson Jr.
• Scott Carlson, MD
• Shawnn Carlson, MA 60593496
• Shirley Joanne Carlson, P.T.
• Stephen Carlson, MD
• Zachary T Carlson, M.D.
• Zachary Wayne Carlson, APRN
• Stephani Fae Carlton, LMHC
• Melissa Carmona
• Merribel Carmona

• Speech-Language Pathologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.