Individual provider Active NPI

Lisa Yvonne Carroll, LCSW

  • Clinical Social Worker
  • Tuscaloosa, AL
National Provider Identifier
1538251392
Registry record updated Jan 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2467C Issued in AL
Practice address
2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235
Phone
(205) 349-3250
Fax
(205) 752-1517
NPI assigned
Sep 29, 2006
Last updated
Jan 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2467C AL Primary

Addresses

Primary practice location

2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235

Mailing address

2731 Martin Luther King Blvd
Tuscaloosa, AL 35401-5235
Phone (205) 349-3250

Other names 1

  • Lisa Yvonne Bullington Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121217000114 AL Practitioner - Clinical Social Worker 1850543042 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Alabama School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MCCD FL Psychiatry Services PAGroup PAC ID 4880064070, 751 clinicians

Practice addresses (Care Compare)

Mobile, AL 36606
Phone (833) 351-8255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2467CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whatley Health Services Inc CurrentSince Jan 1, 2020 Accepting new patients
Whatley Health Services, Inc. CurrentSince Jan 1, 2020 Accepting new patients
MCCD FL Psychiatry Services PA CurrentSince Jul 6, 2024 Accepting new patients
Mental Health Center of North Central Alabama Inc. PastSince Jul 6, 2019 Accepting new patients

Locations

11 N Water St
Fl 10
Mobile, AL 36602
Phone (205) 860-7878

1850 Airport Blvd
Mobile, AL 36606
Phone (228) 243-9771

2731 Ml King Jr Blvd
Tuscaloosa, AL 35401
Phone (205) 349-3250

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

Organizations & group practices 4

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": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578355200000",
    "number": "1538251392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235",
            "telephone_number": "205-349-3250",
            "fax_number": "205-752-1517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2731 MARTIN LUTHER KING BLVD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354015235",
            "telephone_number": "205-349-3250",
            "fax_number": "205-752-1517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "LISA",
        "middle_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2020-01-07",
        "certification_date": "2020-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2467C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BULLINGTON",
            "middle_name": "YVONNE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.