Carroll, Kenneth Robert
Carroll, Kenneth Robert is an sole proprietor health care provider with primary practice located at 613 Ogden Ave , Swarthmore PA 19081-1132. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Carroll, Kenneth Robert can be contacted via phone (610) 328-6768.Contact Information
Primary practice address
613 Ogden Ave
Swarthmore PA 19081-1132
Phone: (610) 328-6768
Fax: (610) 328-6768
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PS-004152L | Pennsylvania |
Profile Details
| NPI number | 1740341346 |
|---|---|
| LBN Legal business name | Carroll, Kenneth Robert |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 13th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1740341346 | NPPES |
| Pennsylvania | MEDICAID | 01239726 |
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