Active NPI
Doris Ann Carroll, LMHC, MCAP
- Addiction (Substance Use Disorder) Counselor
- Crescent City, FL
National Provider Identifier
1609188549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- MH12013
- Practice address
- 1125 N. Summit St.
Crescent City, FL 32112 - Phone
- (561) 632-5663
- Fax
- (561) 615-0045
- NPI assigned
- Jul 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH12013 | FL | |
| Mental Health Counselor | 101YM0800X | |||
| Substance Use Disorder Rehabilitation Clinic/Center | 261QR0405X | FL | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MH12013 | FL | Primary |
Addresses
Primary practice location
1125 N. Summit St.
Crescent City, FL 32112
Mailing address
P. O. Box 626
Pomona Park, FL 32181
Phone (561) 632-5663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH12013 | Other | FL | DEPARTMENT OF HEALTH |
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 |
|---|---|---|---|
| MH12013 | FL | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661126400000",
"number": "1609188549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P. O. BOX 626",
"city": "POMONA PARK",
"state": "FL",
"postal_code": "32181",
"telephone_number": "561-632-5663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1125 N. SUMMIT ST.",
"city": "CRESCENT CITY",
"state": "FL",
"postal_code": "32112",
"telephone_number": "561-632-5663",
"fax_number": "561-615-0045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "DORIS",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "LMHC, MCAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2022-08-22",
"certification_date": "2022-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH12013",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0405X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "FL",
"license": "MH12013",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF HEALTH",
"identifier": "MH12013",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Crescent City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.