Carroll, David
Carroll, David is an individual health care provider with primary practice located at 1751 Tower Dr W Ste 200 , Stillwater MN 55082-7596. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Carroll, David can be contacted via phone (651) 439-2059.Contact Information
Primary practice address
1751 Tower Dr W Ste 200
Stillwater MN 55082-7596
Phone: (651) 439-2059
Fax: (888) 675-8262
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2633 | Minnesota |
Profile Details
| NPI number | 1205913290 |
|---|---|
| LBN Legal business name | Carroll, David |
| Credentials | PSYD, LP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | Nov 5th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205913290 | NPPES |
| Minnesota | MEDICAID | 1205913290 |
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