Derek R. Carroll, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC47238 Issued in CA

Practice address

30011 Ivy Glenn Dr
Suite 221
Laguna Niguel, CA 92677-5014

Phone

(949) 338-5891

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

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.

• Nicole Gerth

  • Community/Behavioral Health Agency
  • Laguna Niguel, CA
  • NPI 1407181316
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266451200000",
    "number": "1699836080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30011 IVY GLENN DR",
            "address_2": "SUITE 221",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775014",
            "telephone_number": "949-338-5891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30011 IVY GLENN DR",
            "address_2": "SUITE 221",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926775014",
            "telephone_number": "949-338-5891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "DEREK",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2010-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC47238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Nguyen Cao, PHARMD
• Capistrano Unified School District
• Cardiac Imaging Inc
• Warner W Carr, MD
• Abigail Fabunan Carrasco, OTR/L
• Tommy Casarrubias - Ascencio
• Cascade ABA Services
• Dennis P. Cassan, LCSW
• Daniel Joseph Cerfogli, DPT
• Michael Anthony Cerni, D.O.

• Marriage & Family Therapist in Laguna Niguel, CA
• Providers in Laguna Niguel, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.