Jerry Monroe Carroll

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1227 Ansel Rd
Cleveland, OH 44108-3323

Phone

(216) 421-0662

NPI assigned

Oct 28, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Hitchcock Center for Women, Inc

  • Substance Abuse Rehabilitation Facility
  • Cleveland, OH
  • NPI 1275598419
  NPD (past)

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1205479789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 EVANGELINE RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441103151",
            "telephone_number": "216-512-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 ANSEL RD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441083323",
            "telephone_number": "216-421-0662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23201 Lake Shore Blvd Apt 44",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441231340",
            "country_code": "US",
            "telephone_number": "216-403-2960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JERRY",
        "middle_name": "MONROE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-28",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cleveland",
            "affiliation": "N",
            "address_1": "23201 Lake Shore Blvd Apt 44",
            "city": "Euclid",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441231340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "cleveland",
            "affiliation": "N",
            "address_1": "23201 Lake Shore Blvd Apt 44",
            "city": "Euclid",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441231340",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "jcarroll@hcfw.org",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "1227 Ansel Rd",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441083323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mariangel Carrion, CDCA
• Julia Carroccio
• Edward Nicholas Carrol, PHD
• Demerria Carroll-Durden
• Colleen Carroll, CNP
• Kara Carroll, CNP
• Leslie Carroll
• Marion Carroll, MD
• Melanie Elaine Carroll, M.A., CCC-SLP
• Ronsheika Sharice Carroll, LPN

• Addiction (Substance Use Disorder) Counselor in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

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