Provider Demographics
NPI:1396522249
Name:CARROLL PSYCHIATRIC SERVICES PLLC
Entity type:Organization
Organization Name:CARROLL PSYCHIATRIC SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:CARROLL
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, RN
Authorized Official - Phone:978-273-9575
Mailing Address - Street 1:81 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1329
Mailing Address - Country:US
Mailing Address - Phone:978-273-9575
Mailing Address - Fax:
Practice Address - Street 1:1 ARNOLD CIR STE 7
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-2250
Practice Address - Country:US
Practice Address - Phone:617-397-4737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty