NPIMap

Organization Active NPI

Carroll Psychological Services, Inc.

  • Clinical Psychologist
  • Willmar, MN
National Provider Identifier
1043275688
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP1747 Issued in MN
Legal business name
CARROLL PSYCHOLOGICAL SERVICES, INC.
Practice address
214 4TH St SW
Willmar, MN 56201-3330
Phone
(320) 214-7733
NPI assigned
Apr 18, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Patrick J. Carroll, M.A.NPI 1235194382
Title
Licensed Psychologist
Phone
(320) 214-7733

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X LP1747 MN Primary

Addresses

Primary practice location

214 4TH St SW
Willmar, MN 56201-3330

Mailing address

PO Box 1569
Willmar, MN 56201-1569
Phone (320) 214-7733

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043275688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1569",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562011569",
            "telephone_number": "320-214-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 4TH ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "562013330",
            "telephone_number": "320-214-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "320-214-7733",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willmar, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.