Individual provider Active NPI

Cynthia M Carroll, ITFS, M.ED

  • Behavior Analyst
  • Fayetteville, NC
National Provider Identifier
1346564309
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
17605 Issued in NC
Practice address
1708A Owen Dr
Fayetteville, NC 28304-3419
Phone
(910) 425-6282
Fax
(910) 425-6554
NPI assigned
Mar 19, 2010
Last updated
Jun 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 17605 NC Primary
Developmental Therapist 222Q00000X 8300047K NC

Addresses

Primary practice location

1708A Owen Dr
Fayetteville, NC 28304-3419

Mailing address

1708A Owen Dr
Fayetteville, NC 28304-3419
Phone (910) 425-6282

Other practice location 1

1184 Fayetteville Rd
Raeford, NC 28376-2536
Phone (910) 527-5999

Other practice location 2

2722 Fort Bragg Rd
Fayetteville, NC 28303-4721
Phone (910) 425-6282

Other practice location 3

310A Bratton Dr
Garner, NC 27529-7827
Phone (910) 527-5999

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
8300047KNCMDDevelopmental Therapist
17605NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Early Intervention Services, LLC Behavior Analyst Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1346564309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708A OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043419",
            "telephone_number": "910-425-6282",
            "fax_number": "910-425-6554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708A OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043419",
            "telephone_number": "910-425-6282",
            "fax_number": "910-425-6554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1184 Fayetteville Rd",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283762536",
            "country_code": "US",
            "telephone_number": "910-527-5999",
            "fax_number": "910-425-6554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2722 Fort Bragg Rd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283034721",
            "country_code": "US",
            "telephone_number": "910-425-6282",
            "fax_number": "910-425-6554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310A Bratton Dr",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275297827",
            "country_code": "US",
            "telephone_number": "910-527-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "CYNTHIA",
        "middle_name": "M",
        "credential": "ITFS, M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-19",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NC",
            "license": "17605",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NC",
            "license": "8300047K",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.