Amy Christine Carroll

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13718 Issued in MN

Practice address

4151 Thomas Ave N
Minneapolis, MN 55412-1517

Phone

(612) 310-8683

NPI assigned

Apr 1, 2022

Sex

Female

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

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.

• Northside Center for Emotional Wellness LLC

  • Psychologist
  • Minneapolis, MN
  • NPI 1518332709
  NPD (past)
• Northside Center for Emotional Wellness LLC

  • Clinical Child & Adolescent Psychologist
  • Minneapolis, MN
  • NPI 1629522081
  NPD (past)

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1831839265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4151 THOMAS AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 THOMAS AVE N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554121517",
            "telephone_number": "612-310-8683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alonso Carrasco Jr., MD
• Rochelle L Carrick, LICSW
• Claire Susannah Carrier, PA
• Angela Carrillo, RN
• Carol A Carroll-Maier, R.N.
• Brian Jeffrey Carroll, MD
• Ginger Lynn Carroll, OTR
• Javae Lashel Carroll, LICSW
• Joseph Thomas Carroll, MD
• Judith Tammy Carroll, FNP

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.