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General NPI Number Information
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NPI Number | 1154225720
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Entity Type | Individual
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Provider Name | ERIK RICH CARROLL
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Gender | Male
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 13160 COUNTY ROAD 3610
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City | SAINT JAMES
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State | MO
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Zip | 65559-9151
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Country | US
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Telephone | 844-424-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 21021 LACOMBE RD
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City | WAYNESVILLE
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State | MO
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Zip | 65583-3107
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Country | US
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Telephone | 904-710-6489
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2026042701
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License Number State | MO
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