Individual provider Active NPI

Shelia M Carroll, PH.D, LP

  • Psychologist
  • Landover, MD
National Provider Identifier
1164088258
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
04015 Issued in MD
Practice address
8240 Professional PL Ste 200
Landover, MD 20785-2215
Phone
(301) 577-4470
Fax
(301) 577-4123
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 04015 MD Primary

Addresses

Primary practice location

8240 Professional PL Ste 200
Landover, MD 20785-2215

Mailing address

3934 Emblem Cor
Bowie, MD 20716-3223
Phone (240) 383-7974

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
04015MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Essential Therapeutic Perspectives, Inc CurrentSince Apr 1, 2023 Accepting new patients
Essential Therapeutic Perspectives, Inc CurrentSince Dec 10, 2023 Accepting new patients

Locations

8240 Professional Pl
Ste 200
Landover, MD 20785
Phone (301) 577-4440

8100 Professional Pl
Ste 200
Landover, MD 20785
Phone (301) 577-4440

Organizations & group practices 2

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": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1164088258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 EMBLEM COR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163223",
            "telephone_number": "240-383-7974",
            "fax_number": "301-577-4123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 PROFESSIONAL PL STE 200",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207852215",
            "telephone_number": "301-577-4470",
            "fax_number": "301-577-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "SHELIA",
        "middle_name": "M",
        "credential": "PH.D, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "04015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Landover, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.