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General NPI Number Information
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NPI Number | 1790640225
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Entity Type | Organization
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Legal Business Name | CARROLL PSYCHOTHERAPY, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 510 MAIN AVE STE 7
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City | BROOKINGS
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State | SD
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Zip | 57006-2010
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Country | US
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Telephone | 605-865-4105
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Fax | 605-443-1320
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Provider Business Mailing Address
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Address Line | 510 MAIN AVE STE 7
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City | BROOKINGS
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State | SD
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Zip | 57006-2010
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Country | US
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Telephone | 605-865-4105
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Fax | 605-443-1320
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | KELSEY CARROLL
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Credential | LCSW- PIP
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Telephone | 605-865-4105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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