Individual provider Active NPI

Sierra Brianne Carroll

  • Professional Counselor
  • Glendale, AZ
National Provider Identifier
1093254237
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
95895 Issued in TX
Practice address
17215 N 72ND Dr
Glendale, AZ 85308-8558
Phone
(623) 533-4912
NPI assigned
Feb 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 95895 TX Primary

Addresses

Primary practice location

17215 N 72ND Dr
Glendale, AZ 85308-8558

Mailing address

3646 W Wethersfield Rd
Phoenix, AZ 85029-2126
Phone (903) 348-0813

Other names 1

  • Sierra Brianne Tucker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250604004032 TX Practitioner - Mental Health Counselor 6103335641 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychological Care Dallas I, LLC Counselor CurrentSince May 5, 2025 Accepting new patients

Locations

9009 Forest Ln
Dallas, TX 75243
Phone (972) 783-1771

1900 Oneal St
Gainesville, TX 76240
Phone (940) 665-2826

4635 Southwest Fwy
Ste 635
Houston, TX 77027
Phone (214) 923-7777

434 Paza Dr
Mesquite, TX 75149
Phone (972) 286-6489

1816 Tile Factory Rd
Palestine, TX 75803
Phone (903) 723-0950

7146 Baker Blvd
Richland Hills, TX 76118
Phone (817) 589-1734

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1093254237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3646 W WETHERSFIELD RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850292126",
            "telephone_number": "903-348-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 N 72ND DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088558",
            "telephone_number": "623-533-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "SIERRA",
        "middle_name": "BRIANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-21",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "95895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIERRA",
            "last_name": "TUCKER",
            "middle_name": "BRIANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.