Jessica Elizabeth-Rose Carroll, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY-1813 Issued in HI

Practice address

11-3059 Plumeria Street
Mountain View, HI 96771-1570

Phone

(808) 255-4247

NPI assigned

Jul 31, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Ka Hoku Kai Counseling Center, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Hilo, HI
  • NPI 1043859200
  NPD Authorized official

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1306222401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711570",
            "city": "MOUNTAIN VIEW",
            "state": "HI",
            "postal_code": "967711570",
            "telephone_number": "808-255-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11-3059 PLUMERIA STREET",
            "city": "MOUNTAIN VIEW",
            "state": "HI",
            "postal_code": "967711570",
            "telephone_number": "808-255-4247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH-ROSE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "HI",
            "license": "PSY-1813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali'I Care Hawaii Corp
• Aloha Integrative Mental Health
• Aloha Integrative Mental Health
• Stephen Aston II, MSW, LSW
• Sarah Blechman, LCSW
• Malie Josette Clarisse Carvalho, LCSW
• Comprehensive Autism Spectrum Therapies
• Anthony M Conner, PHLEBOTOMY CERTIFICA
• Counseling Services of Hawaii LLC
• Holly Alexandra Davis

• All providers in Mountain View, HI
• Clinical Psychologist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.