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General NPI Number Information
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NPI Number | 1609188549
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Entity Type | Individual
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Provider Name | DORIS ANN CARROLL LMHC, MCAP
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Gender | Female
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 1125 N. SUMMIT ST.
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City | CRESCENT CITY
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State | FL
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Zip | 32112
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Country | US
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Telephone | 561-632-5663
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Fax | 561-615-0045
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Provider Business Mailing Address
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Address Line | P. O. BOX 626
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City | POMONA PARK
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State | FL
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Zip | 32181
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Country | US
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Telephone | 561-632-5663
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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 | MH12013
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License Number State | FL
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | MH12013
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License Number State | FL
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