Active NPI
Angela Y Carroll, MA, LPC
- Mental Health Counselor
- Beaufort, SC
National Provider Identifier
1366753147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1050 Ribaut Rd
Beaufort, SC 29902-5400 - Phone
- (843) 524-3378
- NPI assigned
- Jun 28, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary | ||
| Professional Counselor | 101YP2500X | 5560 | SC |
Addresses
Primary practice location
1050 Ribaut Rd
Beaufort, SC 29902-5400
Mailing address
1050 Ribaut Rd
Beaufort, SC 29902-5400
Phone (843) 524-3378
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 121328 | Medicaid | SC |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5560 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1366753147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 RIBAUT RD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299025400",
"telephone_number": "843-524-3378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 RIBAUT RD",
"city": "BEAUFORT",
"state": "SC",
"postal_code": "299025400",
"telephone_number": "843-524-3378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "ANGELA",
"middle_name": "Y",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-28",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "5560",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121328",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Beaufort, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.