Active NPI
Theodore L Carroll, PHD, LMHC, NCC
- Marriage & Family Therapist
- Richland, WA
National Provider Identifier
1962021212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MG60947452
- Practice address
- 603 Knight St Ste D
Richland, WA 99352-3800 - Phone
- (509) 870-7853
- Fax
- (509) 943-2129
- NPI assigned
- Apr 15, 2020
- Last updated
- Nov 16, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LH61050462 | WA | |
| Marriage & Family Therapist | 106H00000X | MG60947452 | WA | Primary |
Addresses
Primary practice location
603 Knight St Ste D
Richland, WA 99352-3800
Mailing address
603 Knight St Ste D
Richland, WA 99352-3800
Phone (509) 870-7853
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LH61050462 | Other | WA | LICENSING CREDENTIALS |
| MG60947452 | Other | WA | LICENSING CREDENTIALS |
Other names 1
- Dr. Ted L Carroll
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH61050462 | WA | MD | Counselor |
| MG60947452 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1962021212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 KNIGHT ST STE D",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523800",
"telephone_number": "509-870-7853",
"fax_number": "509-943-2129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 KNIGHT ST STE D",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523800",
"telephone_number": "509-870-7853",
"fax_number": "509-943-2129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "THEODORE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD, LMHC, NCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-15",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "WA",
"license": "LH61050462",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "MG60947452",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSING CREDENTIALS",
"identifier": "LH61050462",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSING CREDENTIALS",
"identifier": "MG60947452",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TED",
"last_name": "CARROLL",
"middle_name": "L",
"prefix": "DR.",
"credential": "PHD, LMHC, NCC",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.