Active NPI
Thomas Patrick Carroll, L.P.C.
- Professional Counselor
- Racine, WI
National Provider Identifier
1447695481
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4208
- Practice address
- 1320 Wisconsin Ave
Racine, WI 53403-1978 - Phone
- (262) 687-2222
- NPI assigned
- May 3, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4208-125 | WI | |
| Professional Counselor | 101YP2500X | 4208 | WI | Primary |
Addresses
Primary practice location
1320 Wisconsin Ave
Racine, WI 53403-1978
Mailing address
1320 Wisconsin Ave
Racine, WI 53403-1978
Phone (262) 687-2222
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4208-125 | WI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1447695481",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "THOMAS",
"middle_name": "PATRICK",
"name_prefix": "Mr.",
"credential": "L.P.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-03",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WI",
"license": "4208-125",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "4208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
- Sofia Carias, SLP
- Caring Hearts Afh LLC
- Caring Hearts House Afh LLC
- Karen Carnabucci, MSS, LCSW, TEP
- Marjorie Jane Carrington, R.D.
- Veronica Carver, MD
- Mallory Casey, M.S.CCC-SLP
- Catholic Charities of the Archdiocese of Milwaukee Inc
- Catholic Charities of the Archdiocese of Milwaukee Inc
- Randall C. Cech, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.