John Lee Carroll Jr., LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11774 Issued in MD

Practice address

1821 Portal St Ste B
Baltimore, MD 21224-6541

Phone

(410) 633-4236

Fax

(410) 633-4316

NPI assigned

Mar 13, 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

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": "1552435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1225597990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 PORTAL ST STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212246541",
            "telephone_number": "410-633-4236",
            "fax_number": "410-633-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 PORTAL ST STE B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212246541",
            "telephone_number": "410-633-4236",
            "fax_number": "410-633-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JOHN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-13",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "11774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chante Carroll, AG-ACNP-BC
• Christopher Patrick Carroll, M.D.
• Danna Celeste Carroll, LCSW-C
• Erica Carroll, LMSW
• Irene Carroll, LCSW-C
• Karen Colleen Carroll, M.D.
• Katrina Carroll
• Khailen Deshun Carroll
• Maleiah Carroll, OD
• Maria M. Carroll, MSSW, PH.D.

• Clinical Social Worker in Baltimore, MD
• Providers in Baltimore, 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 Mar 13, 2019; 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.