Active NPI
Carroll Evertson, LMHC
- Mental Health Counselor
- Pembroke Pines, FL
National Provider Identifier
1336169267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MH6745
- Practice address
- 1150 Hibiscus Dr
Pembroke Pines, FL 33025-4554 - Phone
- (954) 967-6300
- NPI assigned
- Jul 21, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH6745 | NU | Primary |
Addresses
Primary practice location
1150 Hibiscus Dr
Pembroke Pines, FL 33025-4554
Mailing address
4100 Vinkemulder Rd
Coconut Creek, FL 33073-3433
Phone (954) 967-6300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336169267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 VINKEMULDER RD",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330733433",
"telephone_number": "954-967-6300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 HIBISCUS DR",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330254554",
"telephone_number": "954-967-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVERTSON",
"first_name": "CARROLL",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": "MH6745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- 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.