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General NPI Number Information
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NPI Number | 1124766308
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Entity Type | Individual
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Provider Name | AMBERLE DAWN CARROLL BA
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Gender | Female
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Dates
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Enumeration Date | 05/26/2022
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Last Update Date | 10/21/2025
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Provider Practice Location Address
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Address Line | 7441 BARTLETT ST NE STE 1B
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-5916
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Country | US
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Telephone | 505-600-6631
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Fax |
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Provider Business Mailing Address
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Address Line | 3407 EDGEMONT DR
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City | MIDLAND
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State | TX
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Zip | 79707-4218
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2024-0512
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LAC-22004
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License Number State | AZ
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