Individual provider Active NPI

Brenda M. Carroll, LCPC

  • Counselor
  • Towson, MD
National Provider Identifier
1033514807
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LC5859 Issued in MD
Practice address
7402 York Road
Suite 300
Towson, MD 21204-7522
Phone
(443) 529-6623
NPI assigned
Oct 23, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCA2422 MD
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00204000 NJ
Counselor 101Y00000X LC5859 MD Primary

Addresses

Primary practice location

7402 York Road
Suite 300
Towson, MD 21204-7522

Mailing address

7402 York Road
Suite 300
Towson, MD 21204-7522
Phone (443) 529-6623

Other practice location 1

1501 S. Clinton Street
Mailstop CT 05-13
Baltimore, MD 21224
Phone (443) 529-6623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC5859MDMDCounselor
LCA2422MDMDAddiction (Substance Use Disorder) Counselor
37LC00204000NJMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1033514807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7402 YORK ROAD",
            "address_2": "SUITE 300",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047522",
            "telephone_number": "443-529-6623",
            "fax_number": "410-825-6038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7402 YORK ROAD",
            "address_2": "SUITE 300",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047522",
            "telephone_number": "443-529-6623"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 S. Clinton Street",
            "address_2": "Mailstop CT 05-13",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "21224",
            "country_code": "US",
            "telephone_number": "443-529-6623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "BRENDA",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA2422",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00204000",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "LC5859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.