Sara Ellen Carrillo, MSW, LICSW,MHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00009454 Issued in WA

Practice address

Child and Family Behavioral Health Services
9040 Jackson Ave
Tacoma, WA 98531-0001

Phone

(253) 968-4843

NPI assigned

Sep 25, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: saracarrillo@tdh.allscriptsdirect.net

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.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1942497789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER",
            "address_2": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "985310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILD AND FAMILY BEHAVIORAL HEALTH SERVICES",
            "address_2": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "985310001",
            "telephone_number": "253-968-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "SARA",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LICSW,MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "LW00009454",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3971",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00009454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MADIGAN ARMY MEDICAL CENTER",
            "identifier": "NONE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNKNOWN",
            "identifier": "UNKNOWN",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Carratelli, LMHCA
• Amanda Carrell
• Myra Drew Carreon, M.D.
• Isabella Pia Carreras-Thresher
• Francesca E Carreras-Velez
• Maria Theresa Carrington, LCSW
• Jennifer Carroll
• Katelyn Carroll
• Mia Elizabeth Carroll, RPH
• Steven Randall Carroll II

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.