Provider Demographics
NPI:1083813471
Name:CARROLL, ERIN MAY (LPC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MAY
Last Name:CARROLL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-5934
Mailing Address - Country:US
Mailing Address - Phone:479-790-9473
Mailing Address - Fax:479-442-7112
Practice Address - Street 1:230 W CENTER ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5934
Practice Address - Country:US
Practice Address - Phone:479-790-9473
Practice Address - Fax:479-442-7112
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
ARP0605029101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator