Carroll, Jacqueline

Carroll, Jacqueline is an sole proprietor health care provider with primary practice located at 3901 N College Ave Suite 135, Indianapolis IN 46205-2734. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Carroll, Jacqueline can be contacted via phone (317) 931-8018.

Contact Information

Primary practice address
3901 N College Ave Suite 135 Indianapolis IN 46205-2734
Phone: (317) 931-8018
Fax: (317) 931-0943
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 3900022A Indiana
Behavioral Health & Social Service Providers / Pastoral 101YP1600X 39000822A Indiana
Behavioral Health & Social Service Providers / Professional 101YP2500X 39000822A Indiana
Behavioral Health & Social Service Providers / Counselor 101Y00000X 39000822A Indiana

Profile Details

NPI number 1851431258
LBN Legal business name Carroll, Jacqueline
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2007
Last updated Feb 13th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851431258 NPPES
Indiana MEDICAID 300022920

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