Carroll, Theodore L

Carroll, Theodore L is an sole proprietor health care provider with primary practice located at 603 Knight St Ste D , Richland WA 99352-3800. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Carroll, Theodore L can be contacted via phone (509) 870-7853.

Contact Information

Primary practice address
603 Knight St Ste D Richland WA 99352-3800
Phone: (509) 870-7853
Fax: (509) 943-2129
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X LH61050462 Washington
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X MG60947452 Washington

Profile Details

NPI number 1962021212
LBN Legal business name Carroll, Theodore L
Credentials PHD, LMHC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 15th, 2020
Last updated Nov 16th, 2023 - about last year

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 1962021212 NPPES
Washington Other MG60947452 LICENSING CREDENTIALS
Washington Other LH61050462 LICENSING CREDENTIALS

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