Michelle Carroll, LICSW, BCD

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

Kimbrough Ambulatory Care Center
2480 Llewellyn Ave.
Ft Meade, MD 20755

Phone

(301) 677-8270

NPI assigned

Dec 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1194880666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER,",
            "address_2": "3551 ROGER BROOKE DRIVE,",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-539-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KIMBROUGH AMBULATORY CARE CENTER",
            "address_2": "2480 LLEWELLYN AVE.",
            "city": "FT MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "301-677-8270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Brooke Army Medical Center,",
            "address_2": "3551 Roger Brooke Drive,",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "78234",
            "country_code": "US",
            "telephone_number": "210-539-9582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHELLE",
        "credential": "LICSW, BCD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Enanga Burnley, MD
• Yvette C Burrowes, M.D.
• Benjamin Byington, DMD
• Michael Guy Cammack, PHD
• Corey Campbell
• Lindsay Castor
• Willie T CHI, DDS
• Nam Chun, PHARMD
• Jin Y Chung, DDS
• Karen B. Cleaver, FNP

• Clinical Social Worker in Ft Meade, MD
• Providers in Ft Meade, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.