Regina M Carroll LCSW Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

REGINA M CARROLL LCSW INC

Practice address

4509 Whitechapel Dr
Virginia Beach, VA 23455-6447

Phone

(757) 460-4655

NPI assigned

Jan 28, 2022

Organization subpart

No

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

Authorized official

Name

Regina M CarrollNPI 1407866197

Title

Owner

Phone

(757) 460-4655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Regina M Carroll, LCSW

  • Clinical Social Worker
  • Virginia Beach, VA
  • NPI 1407866197
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1083367213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 WHITECHAPEL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556447",
            "telephone_number": "757-460-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 WHITECHAPEL DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556447",
            "telephone_number": "757-460-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGINA M CARROLL LCSW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-28",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-460-4655"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.