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Individual

JOHN M CAROLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPCC

Contact information

Practice address
814 MADISON AVE, COVINGTON, KY 41011
(855) 591-0092
(606) 329-1530
Mailing address
3754 HERITAGE POINTE BLVD, MASON, OH 45040-7628
(606) 923-9042

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1384
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30610026
KY
Enumeration date
07/18/2012
Last updated
08/27/2018
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