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NPI Code Detail

MEDICARE: MRS. TOYA CARROLL M.A., LPC

MEDICARE: MRS. TOYA CARROLL M.A., LPC
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
1101YP2500XProfessional Counselor2009035750MO

General Provider Information

NPI Number : 1639409899
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TOYA CARROLL M.A., LPC
Provider Business Mailing Address
First Line : 11650 NEW HALLS FERRY RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63033-6924
Country : US
Telephone Number : 314-657-5304
Fax Number : 314-735-4240
Provider Business Practice Location Address
First Line : 11650 NEW HALLS FERRY RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63033-6924
Country : US
Telephone Number : 314-657-5304
Fax Number : 314-735-4240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2010
Last Update Date : 03/14/2013

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