Carroll, Marianne Roberts

Carroll, Marianne Roberts is an individual health care provider with primary practice located at 387 Tuckie Rd D, North Windham CT 06256-1355. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Carroll, Marianne Roberts can be contacted via phone (860) 423-4279.

Contact Information

Primary practice address
387 Tuckie Rd D North Windham CT 06256-1355
Phone: (860) 423-4279
Fax: (860) 423-4284
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000055 Connecticut

Profile Details

NPI number 1417056060
LBN Legal business name Carroll, Marianne Roberts
Credentials MA LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2006
Last updated Oct 1st, 2014 - about 10 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 1417056060 NPPES
Connecticut MEDICAID 004255007
Connecticut Other 199589
Connecticut Other P2633664
Connecticut Other 165927
Connecticut Other 300000055CT01

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