McCrae Paxton Carroll, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

9598 Issued in SC

Practice address

108 Central Ave Ste 5
Goose Creek, SC 29445-3079

Phone

(803) 450-6479

Fax

(843) 604-8171

NPI assigned

Sep 14, 2019

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• McCrae Carroll Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Mended Therapy Group

  • Mental Health Counselor
  • Goose Creek, SC
  • NPI 1124807847
  NPD Authorized official
• Crossroads Treatment Center of Charleston, PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • North Charleston, SC
  • NPI 1114460375
  NPD (past)

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1679123384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 CENTRAL AVE STE 5",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453079",
            "telephone_number": "803-450-6479",
            "fax_number": "843-604-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 CENTRAL AVE STE 5",
            "city": "GOOSE CREEK",
            "state": "SC",
            "postal_code": "294453079",
            "telephone_number": "803-450-6479",
            "fax_number": "843-604-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MCCRAE",
        "middle_name": "PAXTON",
        "name_prefix": "Mr.",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "9598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MCCRAE",
            "last_name": "CARROLL",
            "credential": "MA, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Benjamin Chacko, MD

• Professional Counselor in Goose Creek, SC
• Providers in Goose Creek, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.