Provider Demographics
NPI:1881721454
Name:CARSWELL, LYNN ELLIOTT (SLP)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:ELLIOTT
Last Name:CARSWELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 CARRIAGE TRL
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-8507
Mailing Address - Country:US
Mailing Address - Phone:919-724-7160
Mailing Address - Fax:919-590-1992
Practice Address - Street 1:3227 CARRIAGE TRL
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-8507
Practice Address - Country:US
Practice Address - Phone:919-724-7160
Practice Address - Fax:919-590-1992
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2012-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6833235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1418EOtherBLUE CROSS
NC7412563Medicaid