KELLY CARLSON MACCCSLP NPI 1083749964

NPI Information

  • NPI: 1083749964
  • Provider Name: KELLY CARLSON, MACCCSLP
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Individual
  • Address: 2795 PILOT KNOB RD
    SUITE 100
    EAGAN, MN
    ZIP 55121
  • Phone: (651) 994-9644

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NPI Details

Kelly Carlson, MACCCSLP is a speech language pathologist in Eagan, MN. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. Kelly Carlson, MACCCSLP NPI is 1083749964. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2795 PILOT KNOB RD
SUITE 100
EAGAN, MN
ZIP 55121-119
Phone: (651) 994-9644
Fax: (651) 994-8962

The enumeration date for this NPI number is 2/22/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language Pathologist7663MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1HP42423OTHERMINNESOTAHEALTH PARTNERS
24600723OTHERMINNESOTAMEDICA
3964S0GIOTHERMINNESOTABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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