NPIMap

Organization Active NPI

Mary L Carroll Services, LLC

  • Professional Counselor
  • Laurel, MD
National Provider Identifier
1235472606
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC4022 Issued in MD
Legal business name
MARY L CARROLL SERVICES, LLC
Practice address
14201 Laurel Park Dr
Suite 226
Laurel, MD 20707-5203
Phone
(301) 356-4914
Fax
(240) 554-2381
NPI assigned
Apr 3, 2013
Last updated
Apr 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Authorized official

Name
Mary Carroll, LCPC
Title
Psychotherapist
Phone
(301) 356-4914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X LC4022 MD Primary

Addresses

Primary practice location

14201 Laurel Park Dr
Suite 226
Laurel, MD 20707-5203

Mailing address

14201 Laurel Park Drive
Suite 226
Laurel, MD 20707
Phone (301) 356-4914

Other identifiers 1

IdentifierTypeStateIssuer
334425800MedicaidMD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364947200000",
    "number": "1235472606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DRIVE",
            "address_2": "SUITE 226",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "301-356-4914",
            "fax_number": "240-554-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DR",
            "address_2": "SUITE 226",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075203",
            "telephone_number": "301-356-4914",
            "fax_number": "240-554-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY L CARROLL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "301-356-4914",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC4022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334425800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.