Individual provider Active NPI

Vincent L. Carolan, LCSW, LPC

  • Clinical Social Worker
  • Dallas, PA
National Provider Identifier
1184051617
Registry record updated May 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW019723 Issued in PA
Practice address
39 Idlewood Dr
Dallas, PA 18612-9027
Phone
(570) 706-1591
Fax
(570) 301-6244
NPI assigned
Sep 30, 2013
Last updated
May 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X PC007793 PA
Clinical Social Worker 1041C0700X CW019723 PA Primary

Addresses

Primary practice location

39 Idlewood Dr
Dallas, PA 18612-9027

Mailing address

39 Idlewood Dr
Dallas, PA 18612-9027
Phone (570) 706-1591

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180110000479 PA Practitioner - Clinical Social Worker 3476812850 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)

335 S Franklin St
Wilkes Barre, PA 18702-3808
Phone 5708256425581

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC007793PAMDProfessional Counselor
CW019723PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Service Center of Wyoming Valley, Inc CurrentSince Mar 10, 2025 Accepting new patients
Children's Service Center of Wyoming Valley, Inc Clinical Current Accepting new patients
Children's Service Center of Wyoming Valley, Inc CurrentSince Mar 10, 2025 Accepting new patients

Locations

133 W Tioga St
Tunkhannock, PA 18657
Phone (570) 836-2722

335 S Franklin St
Wilkes Barre, PA 18702
Phone (570) 825-6425

Organizations & group practices 3

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": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777766400000",
    "number": "1184051617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 IDLEWOOD DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129027",
            "telephone_number": "570-706-1591",
            "fax_number": "570-301-6244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 IDLEWOOD DR",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186129027",
            "telephone_number": "570-706-1591",
            "fax_number": "570-301-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLAN",
        "first_name": "VINCENT",
        "middle_name": "L.",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-09-30",
        "last_updated": "2026-05-03",
        "certification_date": "2026-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC007793",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW019723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, PA

Sources for this page

Verify at the official NPI Registry.