Michael Timothy Carroll, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801110612 Issued in MI

Practice address

1603 E 9 Mile Rd
Ferndale, MI 48220-2065

Phone

(248) 514-4955

NPI assigned

Jan 11, 2019

Last updated

Mar 20, 2024By the provider in NPPES

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emotional Advantage LLCGroup PAC ID 7719208842, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emotional Advantage LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ferndale, MI
  • NPI 1447647789
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1547164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1942774054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202065",
            "telephone_number": "248-514-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 E 9 MILE RD",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202065",
            "telephone_number": "248-514-4955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-11",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801110612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth D Calloway
• Peytan Calvert
• Desiree Cameron
• Care for U Medical PC
• Caring Hearts Adult Day Care and Therapeutic Clinic
• Ryan Carruthers
• Center for Therapeutic Arts
• Deena Chabaan, PA-C
• Thomas Champion
• Emily Jean-Peden Chase, LLC, ATR-P

• Clinical Social Worker in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.