Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lacey Michelle Ellsworth, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1164940508

Lacey Michelle Ellsworth, MS, CCC-SLP is a Speech-Language Pathologist in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2017
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

9620 Chesapeake Dr Ste 103
San Diego, CA 92123-1324
Phone: (559) 707-0821
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 24933 (CA)

Record details

NPI number1164940508
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedSeptember 6, 2017
Last updated in NPPESSeptember 6, 2017

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