Nekita Pauline Carroll, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

58.011517 Issued in CT

Practice address

1620 Laurel Ave
Bridgeport, CT 06604-1515

Phone

(203) 953-9629

NPI assigned

Nov 8, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nekita Pauline Carroll-Hall Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1174397343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 LAUREL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041515",
            "telephone_number": "203-953-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 LAUREL AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041515",
            "telephone_number": "203-953-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "NEKITA",
        "middle_name": "PAULINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "58.011517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEKITA",
            "last_name": "CARROLL-HALL",
            "middle_name": "PAULINE",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ann Mary Carone, O.D.
• Paul G Carpenter, D.C.
• Denzel Washington Carr
• Patricia A Carrington
• Alexis Lynn Carroll
• Linda M Carson
• Emily T Carter, APRN
• Meghan Carter, LCSW
• Michael Carter, RN
• Kerry Carton-Milner

• Clinical Social Worker in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.