Active NPI
Carole Groux, LPC
- Mental Health Counselor
- Annapolis, MD
National Provider Identifier
1104965649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC5836
- Practice address
- 1410 Forest Dr Ste 31
Annapolis, MD 21403-1446 - Phone
- (443) 214-8414
- Fax
- (443) 767-4396
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10772 | AZ | |
| Mental Health Counselor | 101YM0800X | 4998 | NC | |
| Mental Health Counselor | 101YM0800X | LC5836 | MD | Primary |
Addresses
Primary practice location
1410 Forest Dr Ste 31
Annapolis, MD 21403-1446
Mailing address
401 Beards Dock Xing
Annapolis, MD 21403-1307
Phone (480) 335-7216
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
| License | State | Type | Specialty |
|---|---|---|---|
| LC5836 | MD | MD | Mental Health Counselor |
| 4998 | NC | MD | Mental Health Counselor |
| 10772 | AZ | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Evolution Counseling and Wellness LLC | Current | Accepting new patients |
Locations
1410 Forest Dr
Ste 31
Annapolis, MD 21403
Phone (443) 214-8414
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Annapolis, MD
- NPI 1184254211
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594857600000",
"number": "1104965649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 BEARDS DOCK XING",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214031307",
"telephone_number": "480-335-7216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 FOREST DR STE 31",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214031446",
"telephone_number": "443-214-8414",
"fax_number": "443-767-4396"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROUX",
"first_name": "CAROLE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2020-07-16",
"certification_date": "2020-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "10772",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "4998",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC5836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Annapolis, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.