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NPI Code Detail

MEDICARE: MRS. STEPHENIE DIANE CARROLL LMFT/ CADC III

MEDICARE: MRS. STEPHENIE DIANE CARROLL LMFT/ CADC III
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106H00000XMarriage & Family TherapistLMFT156118CA

General Provider Information

NPI Number : 1063540607
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHENIE DIANE CARROLL LMFT/ CADC III
Provider Business Mailing Address
First Line : 5080 CALIFORNIA AVE STE 100
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0794
Country : US
Telephone Number : 661-634-9877
Fax Number : 661-864-0198
Provider Business Practice Location Address
First Line : 5080 CALIFORNIA AVE STE 100
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93309-0794
Country : US
Telephone Number : 661-634-9877
Fax Number : 661-864-0198
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2007
Last Update Date : 07/07/2025

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