Healthcare Provider Details

I. General information

NPI: 1982510228
Provider Name (Legal Business Name): RACHEL LYNE CARROLL M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 WILCOX ST
CASTLE ROCK CO
80104-1739
US

IV. Provider business mailing address

16225 PEREGRINE DR
PARKER CO
80134-9357
US

V. Phone/Fax

Practice location:
  • Phone: 303-387-0100
  • Fax:
Mailing address:
  • Phone: 951-514-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number24539572
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: