THERESA LYNN CARROLL (NPI# 1821262254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821262254 |
| Entity Type | Individual |
| Full Name | THERESA LYNN CARROLL |
| Credential | PCC-S |
| Practice Address |
720 19th St Ne Canton OH 44714-2213 |
| Mailing Address |
Po Box 9432 Canton OH 44711-9432 |
| Practice Telephone | 3304911351 |
| Practice Fax Number | 3304919720 |
| Mailing Telephone | 3304911351 |
| Mailing Fax Number | 3304919720 |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
E0003512 | OH | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386875953 | Theresa Marie Carroll | Occupational Therapist | 8526 Meadows Edge Trl, Tinley Park, IL 60487-7069 | 2009-07-30 |
| 1427202423 | Theresa A Carroll | Massage Therapist | 21 Prospect St Ste A, Torrington, CT 06790-6359 | 2008-11-05 |
| 1679704951 | Theresa A Carroll | Physical Therapist | 2106 Executive Dr, Hampton, VA 23666-2402 | 2009-08-04 |
| 1245470491 | Theresa Carroll | Social Worker | 5555 Grossmont Center Dr, Behavioral Health, La Mesa, CA 91942-3019 | 2009-03-01 |
| Street Address |
720 19TH ST NE |
| City | CANTON |
| State | OH |
| Zip Code | 44714-2213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639146095 | Domestic Violence Project, Inc | Clinic/Center | 720 19th St Ne, Canton, OH 44714-2213 | 2006-03-03 |
| 1376062109 | Joseph Fisher | Counselor | 720 19th St Ne, Canton, OH 44714-2213 | 2017-09-13 |
| 1376982736 | Domestic Violence Project, Inc | Clinic/Center | 720 19th St Ne, Canton, OH 44714-2213 | 2013-06-19 |
| 1609149160 | Julie M Evans | Counselor | 720 19th St Ne, Canton, OH 44714-2213 | 2012-02-14 |
| 1497034441 | Lynn Rochelle Jimenez | Counselor | 720 19th St Ne, Canton, OH 44714-2213 | 2011-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164941365 | Desiree Morgan | Occupational Therapy Assistant | 1634 20th St. N.e., Canton, OH 44714 | 2017-09-19 |
| 1932525706 | Cody Henninge | In Home Supportive Care | 2800 Market Ave N Suite 16, Canton, OH 44714 | 2014-03-17 |
| 1346584984 | Quest Recovery and Prevention Services | Substance Abuse Rehabilitation Facility | 1711 Spring Avenue Nw, Canton, OH 44714 | 2012-11-20 |
| 1780159921 | Lynne Marie Shayko | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2018-10-03 |
| 1427437540 | Robert D Cox | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2015-05-21 |
| 1316336878 | Erika D Putnam | Counselor | 1711 Spring Ave Ne, Canton, OH 44714 | 2015-01-21 |
| 1225435969 | Emily A Custer | Counselor | 1341 Market Ave N, Canton, OH 44714 | 2014-11-24 |
| 1700438363 | Ryan Gernert | Specialist/Technologist | 5323 Gardendale Ave Ne, Canton, OH 44714-1042 | 2019-07-14 |
| 1982171468 | Adrienne Chavers | Home Health | 5438 Market Ave N, Canton, OH 44714-1059 | 2018-11-01 |
| 1912061797 | Living 4 Independence | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4629 Helmsworth Dr Ne, Canton, OH 44714-1162 | 2006-12-19 |
| Find all providers in zip 44714 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144766 | Arlicia Lagene Johnson | Counselor | 220 Osmanthus Way, Canton, GA 30114-7197 | 2020-11-03 |
| 1760082309 | Lauren Alyssa Rainey | Counselor | 46522 Aarons Way, Canton, MI 48188-2323 | 2020-10-30 |
| 1134736739 | Janice Marie Mccarthy | Counselor | 12 Old Meadow Ln, Canton, MA 02021-2103 | 2020-09-28 |
| 1497374656 | Brandi Smallwood | Counselor | 147 Clifford Ct, Canton, GA 30115-9336 | 2020-04-08 |
| 1194365098 | Madyna Rancifer | Counselor | 18 Bailey Ct Apt F, Canton, MA 02021-3939 | 2020-01-09 |
| 1942847884 | Joseph Anthony Ashley | Counselor | 3805 Woodland Ave Nw, Canton, OH 44709-2533 | 2019-12-10 |
| 1679117386 | Darryl Wayne Peterson II | Counselor | 3040 Wicker St Ne, Canton, OH 44721-2298 | 2019-11-05 |
| 1376187500 | Breaking Barriers - Hope Is Alive | Counselor | 1920 Schneider St Ne, Canton, OH 44721-3352 | 2019-10-31 |
| 1518529247 | Claude Melbern Aldous | Counselor | 2746 State Highway 68, Canton, NY 13617-3842 | 2019-07-02 |
| 1255834412 | Gorrell Counseling LLC | Counselor | 4501 Hills and Dales Rd Nw Ste 202, Canton, OH 44708-1572 | 2018-03-14 |
| Find all providers in CANTON | ||||
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| 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.