NPIMap

Organization Active NPI

Victoria L Carroll, Pmhnp-BC, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgeland, MS
National Provider Identifier
1679387286
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
VICTORIA L CARROLL, PMHNP-BC, LLC
Practice address
740 Avignon Dr Ste C
Ridgeland, MS 39157-5160
Phone
(601) 937-4552
NPI assigned
Feb 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Authorized official

Name
Victoria Lauren Carroll, PMHNP-BC, MSN, APRNNPI 1427501857
Title
Psychiatric Mental Health NP, Owner
Phone
(901) 490-0093

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

740 Avignon Dr Ste C
Ridgeland, MS 39157-5160

Mailing address

740 Avignon Dr Ste C
Ridgeland, MS 39157-5160
Phone (601) 937-4552

Other identifiers 1

IdentifierTypeStateIssuer
1427501857MedicaidMS

Other names 1

  • Magnolia Psychiatry Doing business as

National Provider Directory

National Provider Directory

Locations

740 Avignon Dr
Ste C
Ridgeland, MS 39157
Phone (601) 937-4552

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738627200000",
    "number": "1679387286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 AVIGNON DR STE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575160",
            "telephone_number": "601-937-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 AVIGNON DR STE C",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575160",
            "telephone_number": "601-937-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA L CARROLL, PMHNP-BC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "LAUREN",
        "authorized_official_title_or_position": "PSYCHIATRIC MENTAL HEALTH NP, OWNER",
        "authorized_official_telephone_number": "901-490-0093",
        "authorized_official_credential": "PMHNP-BC, MSN, APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427501857",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.