Individual provider Active NPI

Edward Clark Carroll, M.A., LPCC

  • Mental Health Counselor
  • Boulder, CO
National Provider Identifier
1245136662
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LPCC.0025314 Issued in CO
Practice address
315 Evergreen Ave
Boulder, CO 80304-2546
Phone
(808) 635-3546
NPI assigned
Oct 14, 2026
Last updated
Oct 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC.0025314 CO Primary

Addresses

Primary practice location

315 Evergreen Ave
Boulder, CO 80304-2546

Mailing address

315 Evergreen Ave
Boulder, CO 80304-2546
Phone (808) 635-3546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1791936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791936000000",
    "number": "1245136662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 EVERGREEN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042546",
            "telephone_number": "808-635-3546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 EVERGREEN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803042546",
            "telephone_number": "808-635-3546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "EDWARD",
        "middle_name": "CLARK",
        "credential": "M.A., LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-14",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0025314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.