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NPI Code Detail

MEDICARE: MARGARET CARROLL

MEDICARE: MARGARET CARROLL
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
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health CounselorPC018420PA

General Provider Information

NPI Number : 1104577618
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARGARET CARROLL
Provider Business Mailing Address
First Line : PO BOX 318
Second Line :
City : YORKLYN
State : DE
Zip : 19736-0318
Country : US
Telephone Number : 302-753-9068
Fax Number :
Provider Business Practice Location Address
First Line : 524 N PROVIDENCE RD
Second Line :
City : MEDIA
State : PA
Zip : 19063-3056
Country : US
Telephone Number : 484-440-9416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2022
Last Update Date : 04/02/2025

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