Active NPI
Charlotte Carroll, LPCC
- Professional Counselor
- Bardstown, KY
National Provider Identifier
1881632628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0356
- Practice address
- 331 South Third Street
Bardstown, KY 40004 - Phone
- (502) 348-9206
- Fax
- (502) 348-6485
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0356 | KY | Primary |
Addresses
Primary practice location
331 South Third Street
Bardstown, KY 40004
Mailing address
331 S 3Rd St
Bardstown, KY 40004-1032
Phone (502) 348-9206
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30605018 | Medicaid | KY | |
| 11574908 | Other | CAQH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0356 | KY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400803200000",
"number": "1881632628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "331 S 3RD ST",
"city": "BARDSTOWN",
"state": "KY",
"postal_code": "400041032",
"telephone_number": "502-348-9206",
"fax_number": "502-348-6485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 SOUTH THIRD STREET",
"city": "BARDSTOWN",
"state": "KY",
"postal_code": "40004",
"telephone_number": "502-348-9206",
"fax_number": "502-348-6485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "CHARLOTTE",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-03",
"last_updated": "2014-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "0356",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30605018",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11574908",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Bardstown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.