Lawrence John Carroll, PHD
Individual provider Active NPI Clinical Psychologist · Washington, DC
NPI 1891995064 · NPPES record last updated Jul 24, 2007
Key facts
- NPI
- 1891995064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1113 (DC)
- Practice address
- 4545 42ND St NW
Suite 204
Washington, DC 20016-4623 - Phone
- (202) 686-1870
- Fax
- (202) 537-1460
- NPI assigned
- Jul 24, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
4545 42ND St NW
Suite 204
Washington, DC 20016-4623
Phone (202) 686-1870
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101222000635 | DC | Practitioner - Clinical Psychologist | 5890983514 | Practice locations: Washington, DC |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1113 | DC | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1113 | DC | Yes |
Addresses
Primary practice location
4545 42ND St NW
Suite 204
Washington, DC 20016-4623
Mailing address
4545 42ND St NW
Suite 204
Washington, DC 20016-4623
Phone (202) 686-1870
Other providers in Washington, DC
- John Edward Carroll
- Jordyn Carroll
- Kayla Carroll
- Kendra Nicole Carroll
- Kira Lee Carroll
- Margaret Carroll
- Mildred Carroll
- Nancy Marie Carroll
- Patricia E Carroll
- Reagan Carroll
All providers in Washington, DC · Clinical Psychologist in District of Columbia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.