Active NPI
Brion Carroll
- Psychologist
- Providence, RI
National Provider Identifier
1225480171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS00774
- Practice address
- 205 Sessions St
Providence, RI 02906-3442 - Phone
- (401) 829-0675
- NPI assigned
- Jul 4, 2016
- Last updated
- Jul 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4207 | MA | |
| Psychologist | 103T00000X | PS00774 | RI | Primary |
Addresses
Primary practice location
205 Sessions St
Providence, RI 02906-3442
Mailing address
205 Sessions St
Providence, RI 02906-3442
Phone (401) 829-0675
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4207 | MA | MD | Psychologist |
| PS00774 | RI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467590400000",
"number": "1225480171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 SESSIONS ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029063442",
"telephone_number": "401-829-0675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 SESSIONS ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029063442",
"telephone_number": "401-829-0675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "BRION",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-07-04",
"last_updated": "2016-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "4207",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS00774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.