Carl Pruitt

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34003308A Issued in IN

Practice address

3016 Lake Shore Dr
Indianapolis, IN 46205-2324

Phone

(317) 253-7387

Fax

(317) 253-7388

NPI assigned

Sep 2, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

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.

• Greenhouse and Associates Inc.

  • Clinical Psychologist
  • Indianapolis, IN
  • NPI 1114237336
  NPD (past)

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942302641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55107",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462050107",
            "telephone_number": "317-253-7387",
            "fax_number": "317-253-7388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3016 LAKE SHORE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462052324",
            "telephone_number": "317-253-7387",
            "fax_number": "317-253-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "CARL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34003308A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Medical Associates LLC
• Providing Ease at Home Care Services, LLC
• Providing Ease Home Health, LLC
• Meredith Price Provost, MD
• Nancy K Pruett, D.D.S.
• Hannah Renee Pruitt, MSED
• Riona Lasha Pruitt
• Tracy Pruitt, LMHCA
• Whitley Pruitt
• Jerrald Scott Pruner, RPH

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, 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 Jul 8, 2007; 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.