Jennifer Ann Carroll, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

110311 Issued in CA

Practice address

2246 N. State College Blvd
Fullerton, CA 92831

Phone

(714) 681-2977

NPI assigned

Jan 31, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548892800000",
    "number": "1982169280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5591",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928380591",
            "telephone_number": "714-681-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2246 N. STATE COLLEGE BLVD",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "92831",
            "telephone_number": "714-681-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2019-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "110311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Carrillo, LCSW
• Carrie M Carrillo, PA
• Daisy Carrillo
• Daniela Carrillo
• Janet Carrillo
• Allison Marie Carson, O.T.R./L
• Danielle Carter, COTA/L
• Jeffery Carter, M.ED
• June D Carter, MSW
• Kericia Carter

• Mental Health Counselor in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.