Jonathan Eric Carroll, KLPC, NCPC, NCCE

Primary specialty

Pastoral CounselorTaxonomy code 101YP1600X

License

148963 Issued in KY

Practice address

318 Saint Elizabeth St
Owensboro, KY 42301-0729

Phone

(270) 925-4922

NPI assigned

Apr 14, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1093396822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 SAINT ELIZABETH ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423010729",
            "telephone_number": "270-925-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 SAINT ELIZABETH ST",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423010729",
            "telephone_number": "270-925-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JONATHAN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "KLPC, NCPC, NCCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": "KY",
            "license": "148963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE-ISSUED LICENSE TO PRACTICE",
            "identifier": "148963",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drcarroll@themongtomgerylinic.com",
            "affiliation": "N",
            "endpointDescription": "confidential email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "318 Saint Elizabeth St",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423010729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carrico Therapy Services LLC
• Amy S Carrico, DMD
• Judy Ann Carrico, ARNP
• Kelsey Alexandra Carrico, OTR
• Matheis W Carrico, MD
• Sarah Carroll, OTA
• Samuel Carson
• Clay A. Carter, PA
• Jamie Carter, D.C., D.O.
• Lawrence Barryman Carter Sr., BA

• Pastoral Counselor in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Pastoral Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.