Individual provider Active NPI

Jessica Lynn Carroll, LMHC

  • Mental Health Counselor
  • Tavares, FL
National Provider Identifier
1720823669
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LMHC17525 Issued in FL
Practice address
101 E Maud St
Tavares, FL 32778
Phone
(352) 253-9348
Fax
(352) 253-9351
NPI assigned
Jul 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LMHC17525 FL Primary

Addresses

Primary practice location

101 E Maud St
Tavares, FL 32778

Mailing address

101 E Maud St
Tavares, FL 32778
Phone (352) 253-9348

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

LicenseStateTypeSpecialty
LMHC17525FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology & Counseling Services PA CurrentSince Jul 7, 2024 Accepting new patients
Counseling & Development Center Inc CurrentSince Jul 7, 2024 Accepting new patients

Locations

101 E Maud St
Tavares, FL 32778
Phone (352) 253-9348

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1719792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1720823669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MAUD ST",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "32778",
            "telephone_number": "352-253-9348",
            "fax_number": "352-253-9351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "LMHC17525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.