McKenna Carroll, M.A., LBA, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

ABA-B-10214970 Issued in OR

Practice address

1827 NE 44TH Ave Ste 390
Portland, OR 97213-1461

Phone

(503) 963-6494

NPI assigned

Jul 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Behavioral Learning Network - Oregon LLC

  • Behavior Analyst
  • Portland, OR
  • NPI 1780248849
  NPD (past)
• Bregman Cares

  • Behavior Analyst
  • Magnolia, TX
  • NPI 1760115018
  NPD (past)

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1275010472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 1ST AVE",
            "city": "VERNONIA",
            "state": "OR",
            "postal_code": "970641001",
            "telephone_number": "979-525-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 NE 44TH AVE STE 390",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972131461",
            "telephone_number": "503-963-6494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26315 Oak Ridge Dr",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773801962",
            "country_code": "US",
            "telephone_number": "281-651-5120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2515 Superior Rd",
            "address_purpose": "LOCATION",
            "city": "Magnolia",
            "state": "TX",
            "postal_code": "773541431",
            "country_code": "US",
            "telephone_number": "512-940-3869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MCKENNA",
        "credential": "M.A., LBA, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-20",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TX",
            "license": "3097",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "ABA-B-10214970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamison Keith Carroll, OTR/L
• Jessica Anne Carroll
• Jessica Graham Carroll, CRNA
• Kari D Carroll, MS
• Kevin H. Carroll, M.D.
• Megan Molly Carroll, PHARM.D.
• Melissa Ann Carroll, QMHA, CNA
• Michael E Carroll, MD
• Michael Lee Carroll, LMT
• Nicole Jon Carroll, MSW

• All providers in Portland, OR
• Behavior Analyst in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.