Individual
DR. JACQUELINE CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3901 N COLLEGE AVE, SUITE 135, INDIANAPOLIS, IN 46205-2734
(317) 931-8018
(317) 931-0943
Mailing address
3901 N COLLEGE AVE STE 135, INDIANAPOLIS, IN 46205-2734
(317) 789-6108
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
39000822A
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
3900022A
IN
101YP1600X
Pastoral Counselor
39000822A
IN
101YP2500X
Professional Counselor
39000822A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300022920
—
IN
Enumeration date
02/07/2007
Last updated
02/13/2023
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