Rea Carroll

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT115445 Issued in CA

Practice address

564 Mountain Ranch Rd # 5
San Andreas, CA 95249-9782

Phone

(209) 498-2227

Fax

(209) 498-2042

NPI assigned

Feb 12, 2016

Sex

Female

Sole proprietor

Yes

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

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.

• County of Amador

  • Community/Behavioral Health Agency
  • Sutter Creek, CA
  • NPI 1205055886
  NPD (past)
• County of Amador

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Sutter Creek, CA
  • NPI 1699321752
  NPD (past)

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1255790754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 MOUNTAIN RANCH RD # 5",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499782",
            "telephone_number": "209-498-2227",
            "fax_number": "209-498-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 MOUNTAIN RANCH RD # 5",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499782",
            "telephone_number": "209-498-2227",
            "fax_number": "209-498-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "REA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT115445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calaveras Sleep Diagnostics, LLC
• Calaveras Unified School District
• Leslie Calestini
• California Em-I Medical Services, a Medical Corporation
• Rebecca Carrillo, M.D.
• Tiara Carter
• Wendy J Carvajal, DDS
• Adrianna C Castle
• Center for Life Skills Coaching
• Cep America - California

• All providers in San Andreas, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; 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.