Provider Demographics
NPI:1982817854
Name:CARROLL, CATHERINE (LPCC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 SPIELBUSCH AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43624-1360
Mailing Address - Country:US
Mailing Address - Phone:419-244-6711
Mailing Address - Fax:419-244-4860
Practice Address - Street 1:1933 SPIELBUSCH AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43624-1360
Practice Address - Country:US
Practice Address - Phone:419-244-6711
Practice Address - Fax:419-244-4860
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE3173101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health