Individual provider Active NPI

Stephen Paul Carroll, LICSW

  • Clinical Social Worker
  • Lowell, MA
National Provider Identifier
1124369053
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW1140141 Issued in MA
Practice address
161 Jackson St
Lowell, MA 01852-2103
Phone
(978) 937-9700
Fax
(978) 221-6728
NPI assigned
Mar 1, 2013
Last updated
Jun 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ASW 34747 CA
Clinical Social Worker 1041C0700X LCSW80510 CA
Clinical Social Worker 1041C0700X LICSW1140141 MA Primary

Addresses

Primary practice location

161 Jackson St
Lowell, MA 01852-2103

Mailing address

3909 Centre St
San Diego, CA 92103-3410
Phone (619) 692-2077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250626001903 MA Practitioner - Clinical Social Worker 0648782383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

101 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

161 Jackson St
Lowell, MA 01852-2103
Phone (978) 937-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ASW 34747CAMDClinical Social Worker
LCSW80510CAMDClinical Social Worker
LICSW1140141MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lowell Community Health Center, Inc. CurrentSince Jul 21, 2025 Accepting new patients
Lowell Community Health Center, Inc. CurrentSince Jul 21, 2025 Accepting new patients
The LGBT Community Center PastSince Oct 1, 2021 Accepting new patients
The San Diego LGBT Community Center PastSince Oct 1, 2021 Accepting new patients

Locations

101 Jackson St
Lowell, MA 01852
Phone (978) 459-8656

161 Jackson St
Lowell, MA 01852
Phone (978) 746-7867

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1362096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1124369053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 CENTRE ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033410",
            "telephone_number": "619-692-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 JACKSON ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522103",
            "telephone_number": "978-937-9700",
            "fax_number": "978-221-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "STEPHEN",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-01",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW 34747",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW80510",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW1140141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.