Individual
KARI D CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
2311 E BURNSIDE ST, UNIT 203, PORTLAND, OR 97214-1655
(503) 773-0001
Mailing address
2311 E BURNSIDE ST, UNIT 203, PORTLAND, OR 97214-1655
(210) 542-5288
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
R3901
OR
106H00000X
Marriage & Family Therapist
Primary
R3902
OR
Other
Enumeration date
07/07/2015
Last updated
03/17/2018
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