KATHLEEN KELLY CARROLL (NPI# 1376674010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376674010 |
| Entity Type | Individual |
| Full Name | KATHLEEN KELLY CARROLL |
| Credential | M.S., M.A., APRN-BC |
| Practice Address |
805 Westmont Dr Fayetteville NC 28305-4555 |
| Practice Telephone | 9104844061 |
| Practice Fax Number | 9104854069 |
| Mailing Telephone | 9104844061 |
| Mailing Fax Number | 9104854069 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-05-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
6455 | NC | Behavioral Health & Social Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
200401185 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6113055 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710240585 | Kathleen A Carroll | Speech-Language Pathologist | 17100 E Shea Blvd Ste 600, Fountain Hills, AZ 85268 | 2012-06-18 |
| 1285959437 | Kathleen Germaine Carroll | Pharmacist | 158-44 Cross Bay Blvd, Howard Beach, NY 11414 | 2010-03-31 |
| 1093918609 | Kathleen Anne Carroll | Obstetrics & Gynecology | 850 Clairton Blvd Ste 3100, Pittsburgh, PA 15236-4585 | 2007-06-10 |
| 1851436059 | Kathleen Mary Carroll | Nurse Practitioner | 5 Industrial Drive Rogers Outpatient Center, Suite 100, Mashpee, MA 02649 | 2007-02-21 |
| 1104367283 | Kathleen Elizabeth Carroll | Nurse Practitioner | 17 Centre Plaza Dr, Jackson, TN 38305-2862 | 2017-03-09 |
| 1245624675 | Kathleen Carroll | Student in an Organized Health Care Education/Training Program | 11960 Westline Industrial Dr, 201, Saint Louis, MO 63146-3209 | 2015-03-24 |
| 1194076380 | Kathleen Louise Carroll | Dentist | 9 Century Hill Dr, Latham, NY 12110-2113 | 2012-09-27 |
| 1821302514 | Kathleen Mary Carroll | Social Worker | 4660 Palm Ave, San Diego, CA 92154 | 2010-08-05 |
| 1578625588 | Kathleen J. Carroll | Social Worker | 800 Zorn Ave, Louisville, KY 40206-1433 | 2006-12-15 |
| 1518065424 | Kathleen M Carroll | Psychologist | 950 Campbell Ave, Mirecc 151d, West Haven, CT 06516-2770 | 2006-09-21 |
| Street Address |
805 WESTMONT DR |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28305-4555 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831487727 | Jessica Paige Stuart-shor | Counselor | 805 Westmont Dr, Fayetteville, NC 28305-4555 | 2011-07-13 |
| 1205139524 | Jennifer R. Lamberth | Marriage & Family Therapist | 805 Westmont Dr, Fayetteville, NC 28305-4555 | 2010-12-08 |
| 1083947477 | Mona Lisa Rivera | Counselor | 805 Westmont Dr, Fayetteville, NC 28305-4555 | 2009-09-16 |
| 1811167208 | Carenet, Inc | Counselor | 805 Westmont Dr, Fayetteville, NC 28305-4555 | 2008-03-03 |
| 1285764258 | Elizabeth Anne Ramos | Counselor | 805 Westmont Dr, Fayetteville, NC 28305-4555 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437637733 | Shannon S Wiggins | Social Worker | 2525 Raeford Rd Ste A, Fayetteville, NC 28305 | 2018-07-30 |
| 1205345790 | Sarah Elizabeth Hudson | Marriage & Family Therapist | 214 Fairway Dr, Fayetteville, NC 28305 | 2017-09-27 |
| 1336533116 | Avalon Counseling Services Pa | Counselor | 916 B Arsenal Ave, Fayetteville, NC 28305 | 2015-03-19 |
| 1568882827 | Kenneth Brown | Counselor | 901 Arsenal Avenue, Suite, Fayetteville, NC 28305 | 2014-04-24 |
| 1174879423 | Lynette Maxwell Pierce | Dentist | 2537-b Raeford Rd, Fayetteville, NC 28305 | 2012-07-24 |
| 1356640973 | Charlene Jones | Social Worker | 560 Lambert St, Fayetteville, NC 28305 | 2011-03-22 |
| 1659518173 | Christine R Campbell | Speech-Language Pathologist | 2401 Roberson Street, Fayettville, NC 28305 | 2009-01-21 |
| 1588814628 | Zakiya S Karim | Pediatrics | 1327 Robeson Street, Fayetteville, NC 28305 | 2008-09-25 |
| 1710134770 | Bright Heart Healthcare Staffing | Nursing Care | 2504 Rareford Rd, Fayetteville, NC 28305 | 2008-08-21 |
| 1730272402 | Dale A Childers | Dentist | 2409 Robeson Street, Fayetteville, NC 28305 | 2006-10-02 |
| Find all providers in zip 28305 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477189157 | Fatimat Olumayowa Olufunmilayo Agbojeyin | Nurse Practitioner | 105 Emerald Lake Ct, Fayetteville, GA 30215-7748 | 2020-03-13 |
| 1548821069 | Asic Behavioral Health, Pllc | Nurse Practitioner | 6977 Nexus Ct Ste 103, Fayetteville, NC 28304-2651 | 2019-06-25 |
| 1245794387 | Stacey Lasandra Mitchell | Nurse Practitioner | 1415 Highway 85 N Ste 310-390, Fayetteville, GA 30214-7738 | 2019-01-23 |
| 1417206491 | Casey J Scott | Nurse Practitioner | 4001 Cumberland Rd, Fayetteville, NC 28306-6703 | 2012-09-05 |
| 1972510519 | Melodie W. Stembridge | Nurse Practitioner | 1100 No. College Avenue, Vhsa, Fayetteville, AR 72703 | 2006-08-02 |
| 1053313536 | Margaret Jean Davis | Nurse Practitioner | 4276 Legend Avenue, Fayetteville, NC 28303-3497 | 2005-08-15 |
| 1811517469 | Ifeoma Nnani | Nurse Practitioner | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2020-04-23 |
| 1497380414 | Andrew Eisele | Nurse Practitioner | 1955 W Truckers Dr, Fayetteville, AR 72704-5637 | 2020-03-10 |
| 1417582545 | Latoya Harley-dowden | Nurse Practitioner | 806 Hay St, Fayetteville, NC 28305-5312 | 2020-03-09 |
| 1104459114 | Stephanie Bohannon | Nurse Practitioner | 112 W Center St Ste 201, Fayetteville, AR 72701-6073 | 2020-02-18 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28305 |
Please comment or provide details below to improve the information on KATHLEEN KELLY CARROLL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.