Provider Demographics
NPI:1972767812
Name:CARROLL, T SCOTT (MA, LPC)
Entity Type:Individual
Prefix:
First Name:T SCOTT
Middle Name:
Last Name:CARROLL
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W 2ND ST STE 5
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-8515
Mailing Address - Country:US
Mailing Address - Phone:732-534-5375
Mailing Address - Fax:
Practice Address - Street 1:103 W 2ND ST STE 5
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8515
Practice Address - Country:US
Practice Address - Phone:732-534-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00446200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health