# KATHLEEN KELLY CARROLL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376674010
- **Gender:** F
- **Credential:** M.S., M.A., APRN-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | 6455 | NC | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 200401185 | NC | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 05/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6113055 | — | NC |