Individual provider Active NPI

Carole Groux, LPC

  • Mental Health Counselor
  • Annapolis, MD
National Provider Identifier
1104965649
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC5836 Issued in MD
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

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
LC5836MDMDMental Health Counselor
4998NCMDMental Health Counselor
10772AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Evolution Counseling and Wellness LLC CurrentSince Jul 27, 2020 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.

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.

Verify at the official NPI Registry.