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General NPI Number Information
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NPI Number | 1497891915
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Entity Type | Individual
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Provider Name | MAUREEN ELLEN CARROLL LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2000 SOUTH MARKET ST SUITE 203
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City | BRENHAM
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State | TX
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Zip | 77833
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Country | US
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Telephone | 979-830-7170
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Fax | 979-830-7170
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Provider Business Mailing Address
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Address Line | 4714 HOLLY STREET
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City | BELLAIRE
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State | TX
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Zip | 77401
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Country | US
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Telephone | 713-839-9448
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Fax | 713-660-6713
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20195
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 20195
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License Number State | TX
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