Lynn Rae Carroll, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC3486 Issued in ME

Practice address

415 Water St
Ellsworth, ME 04605-2116

Phone

(207) 667-5357

NPI assigned

Nov 8, 2006

Last updated

Jan 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Cornerstone Behavioral Healthcare, LLC

  • Community/Behavioral Health Agency
  • Bangor, ME
  • NPI 1215102850
  Medicare reassignment NPD
• Community Health and Counseling Services

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1508921842
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1124198270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 SIS PORTER ROAD",
            "city": "SEDGWICK",
            "state": "ME",
            "postal_code": "04676",
            "telephone_number": "207-326-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 WATER ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052116",
            "telephone_number": "207-667-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LYNN",
        "middle_name": "RAE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NM",
            "license": "LMHC - 0097841",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ME",
            "license": "CC3486",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ME",
            "license": "LS3891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17384265",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William C Caddoo, DMD
• Mary M Callow, MS, CCC-SLP
• Jennifer Cammack
• Caring Hands of Maine (Caring Hands of Maine Dental Center)
• Duane Carr, PHARMD
• Sharon Carroll, LCSW, CCS
• Amy Louise Case, PA
• Castleberry Dental LLC
• Cec, LLC
• Cesc, LLC

• Mental Health Counselor in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Mental Health Counselor in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.