Carol A. Jarvis, PH.D., LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003589A Issued in IN

Practice address

56218 Parkway Ave
Suite B
Elkhart, IN 46516-9326

Phone

(574) 293-0005

Fax

(574) 293-0019

NPI assigned

Mar 7, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Great Lakes Anesthesia, P.C.

  • Anesthesiology Physician
  • Elkhart, IN
  • NPI 1720039977
  NPD (past)
• Michiana Counseling Group, LLC

  • Clinical Social Worker
  • Elkhart, IN
  • NPI 1396180659
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1922138759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56218 PARKWAY AVE",
            "address_2": "SUITE B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169326",
            "telephone_number": "574-293-0005",
            "fax_number": "574-293-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56218 PARKWAY AVE",
            "address_2": "SUITE B",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169326",
            "telephone_number": "574-293-0005",
            "fax_number": "574-293-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "CAROL",
        "middle_name": "A.",
        "name_prefix": "Ms.",
        "credential": "PH.D., LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003589A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200927670A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darneysia Jackson
• James Jackson, D.O.
• Megan Michelle Jackson, OT
• Neil Sushil Jain, PHARMD
• James L Myers II O.D. P.C.
• Douglas L. Jarvis, D.O.
• James Robert Jastifer, MD
• Kamran Javaid, M.D.
• JCB Anesthesia & Pain Management, PC
• Jeffery a Mark PC

• Clinical Social Worker in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.