Individual provider Active NPI

Thomas Carroll, LPC

  • Mental Health Counselor
  • Madison, WI
National Provider Identifier
1528478286
Registry record updated Aug 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1716 Fordem Ave
Madison, WI 53704-4604
Phone
(608) 221-3511
Fax
(608) 221-3514
NPI assigned
May 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1716 Fordem Ave
Madison, WI 53704-4604

Mailing address

5408 Wild Cherry LN
McFarland, WI 53558-8922
Phone (773) 318-5916

Other identifiers 1

IdentifierTypeStateIssuer
1528478286MedicaidWI

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hhu Xtra Care Inc PastSince Aug 1, 2019 Accepting new patients
Family Service Madison Inc PastSince Aug 1, 2019 Accepting new patients
Children'S Service Society of Wisconsin PastSince Nov 28, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1399161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1528478286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5408 WILD CHERRY LN",
            "city": "MCFARLAND",
            "state": "WI",
            "postal_code": "535588922",
            "telephone_number": "773-318-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 FORDEM AVE",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044604",
            "telephone_number": "608-221-3511",
            "fax_number": "608-221-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "THOMAS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-04",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528478286",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; 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.