Jacqueline Denise Howell Carroll, MS CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0518 Issued in KY

Practice address

4621 Longbridge Lane
Lexington, KY 40515-6135

Phone

(859) 272-7472

NPI assigned

Apr 12, 2007

Sex

Female

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)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306060330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 LONGBRIDGE LANE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156135",
            "telephone_number": "859-272-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 LONGBRIDGE LANE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156135",
            "telephone_number": "859-272-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JACQUELINE",
        "middle_name": "DENISE HOWELL",
        "name_prefix": "Mrs.",
        "credential": "MS CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "0518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy D Carrillo, DO
• Carrington Center for Wellness LLC
• Jailine Valeria Carrion, OD
• Christopher L Carrol
• Brenda Marie Carroll, PHARM.D.
• Justin Bryce Carroll
• Olivia Carroll
• Shelby Layton Carroll, PA
• Sophia Grace Carroll, RBT
• Thomas F Carroll, D.M.D.

• Speech-Language Pathologist in Lexington, KY
• Providers in Lexington, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.