Stephanie Nicole Carroll, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10830 Issued in CT

Practice address

100 Jefferson SQ
Waterbury, CT 06706-1109

Phone

(860) 793-3500

NPI assigned

Oct 19, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephanie.carroll.p1@direct.wheelerclinic.nextgenshare.com

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.

• Wheeler Clinic Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Plainville, CT
  • NPI 1396750840
  Medicare reassignment NPD
• Wheeler Clinic Inc

  • Federally Qualified Health Center (FQHC)
  • Bristol, CT
  • NPI 1790532802
  NPD

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1700337292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 PYTHIAN AVE",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067903713",
            "telephone_number": "860-967-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JEFFERSON SQ",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067061109",
            "telephone_number": "860-793-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "74 East St",
            "address_purpose": "LOCATION",
            "city": "Plainville",
            "state": "CT",
            "postal_code": "060622367",
            "country_code": "US",
            "telephone_number": "860-793-3500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "STEPHANIE",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "3320",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "10830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Bruce Carrin, PSY.D.
• Alexandra Carroll, BA
• Kelly A Carroll, LCSW
• Michael Edward Carroll, LPC
• Nerina I. Carroll
• Zulmarie Cartagena
• Anthony R Carter, MD
• Caitlin Carvalho
• Kimberely Sue Casagni, A.P.R.N.-FNP
• Deborah L Casey, MD

• Clinical Social Worker in Waterbury, CT
• Providers in Waterbury, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.