| Carroll Counseling Center, Llc | |
|
1380 Progress Way Suite 101 Eldersburg MD 21784-6464 | |
| (410) 549-5181 | |
| (410) 549-5182 |
| Full Name | Carroll Counseling Center, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1380 Progress Way, Eldersburg, Maryland |
| Authorized Official Name and Position | Elisabeth Pesce (SECRETARY) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carroll Counseling Center, Llc 1380 Progress Way Suite 101 Eldersburg MD 21784-6464 Ph: (410) 549-5181 | Carroll Counseling Center, Llc 1380 Progress Way Suite 101 Eldersburg MD 21784-6464 Ph: (410) 549-5181 |
| NPI Number | 1710999784 |
|---|---|
| Provider Enumeration Date | 08/11/2006 |
| Last Update Date | 12/22/2022 |
| Certification Date | 12/22/2022 |
| Medicare PECOS PAC ID | 8123919461 |
|---|---|
| Medicare Enrollment ID | O20040324000653 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710999784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Primary |
| Provider Name | Paul E Short |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316988553 PECOS PAC ID: 1557358991 Enrollment ID: I20040501000177 |
| Provider Name | James S Choi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154369379 PECOS PAC ID: 5597787200 Enrollment ID: I20051222000099 |
| Provider Name | Robert C Lea |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184666166 PECOS PAC ID: 4587624457 Enrollment ID: I20070330000460 |
| Provider Name | Laura D Malcy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770597007 PECOS PAC ID: 7315031143 Enrollment ID: I20070924000457 |
| Provider Name | Krista L Beyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508037235 PECOS PAC ID: 5991855074 Enrollment ID: I20090611000150 |
| Provider Name | Sherri B Abraham |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427134642 PECOS PAC ID: 6103979224 Enrollment ID: I20090806000296 |
| Provider Name | Anna Alban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124359583 PECOS PAC ID: 2668665274 Enrollment ID: I20101014001306 |
| Provider Name | Maria T Slodzinski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750554903 PECOS PAC ID: 0840474193 Enrollment ID: I20110411000507 |
| Provider Name | William E Hopkins |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093721904 PECOS PAC ID: 6204002942 Enrollment ID: I20111230000566 |
| Provider Name | Sarah P Reusing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871507103 PECOS PAC ID: 7911173281 Enrollment ID: I20120109000441 |
| Provider Name | Pamela G Hain Koenigsburg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871878785 PECOS PAC ID: 6507177060 Enrollment ID: I20150624002536 |
| Provider Name | Jennifer H Bozenski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437482734 PECOS PAC ID: 5890006233 Enrollment ID: I20150625001819 |
| Provider Name | Connie Blizzard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417142290 PECOS PAC ID: 6406168749 Enrollment ID: I20150630000561 |
| Provider Name | Jennifer Heidler-gary |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306237722 PECOS PAC ID: 4981921509 Enrollment ID: I20160328000445 |
| Provider Name | Shobhit Singh Negi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629051040 PECOS PAC ID: 8224073879 Enrollment ID: I20160621001895 |
| Provider Name | Nashae Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760920144 PECOS PAC ID: 3476839796 Enrollment ID: I20170420001550 |
| Provider Name | Mary Anne Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548747710 PECOS PAC ID: 3870843253 Enrollment ID: I20180905002944 |
| Provider Name | Binta Bojang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235655978 PECOS PAC ID: 8820340359 Enrollment ID: I20181011001842 |
| Provider Name | Jessica L Kirschensteiner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497163786 PECOS PAC ID: 0749532810 Enrollment ID: I20181018000375 |
| Provider Name | Kenneth W Abdul Karim |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689850661 PECOS PAC ID: 5890850572 Enrollment ID: I20181024000572 |
| Provider Name | Olufunke Abidemi Taiwo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861058570 PECOS PAC ID: 2860829561 Enrollment ID: I20200218002827 |
| Provider Name | Theodore Michener |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144886011 PECOS PAC ID: 5496155517 Enrollment ID: I20210611000051 |
| Provider Name | Anjali Jain |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982167185 PECOS PAC ID: 6204234966 Enrollment ID: I20211011000733 |
| Provider Name | Michele L Mccartney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952970170 PECOS PAC ID: 4183014533 Enrollment ID: I20211130000157 |
| Provider Name | Thaddeus Miksinski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376558098 PECOS PAC ID: 0648664342 Enrollment ID: I20220223000334 |
| Provider Name | Roseline Ekema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528720356 PECOS PAC ID: 3779977277 Enrollment ID: I20220228000288 |
| Provider Name | Heather E Lasslett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790255404 PECOS PAC ID: 7810381118 Enrollment ID: I20220302003022 |
| Provider Name | Olukemi R Omogoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801365689 PECOS PAC ID: 2365782729 Enrollment ID: I20220309003149 |
| Provider Name | Fernande Tavia Morgan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023162880 PECOS PAC ID: 5496122285 Enrollment ID: I20221108001779 |
| Provider Name | Kedemah Joseph-fagbuyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558604421 PECOS PAC ID: 8325416274 Enrollment ID: I20221125000168 |
| Provider Name | Vasty Adade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760058069 PECOS PAC ID: 9032583521 Enrollment ID: I20230323003114 |
| Provider Name | Vanessa Hong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881328458 PECOS PAC ID: 5991167694 Enrollment ID: I20230811002468 |
| Provider Name | Mark Richard Cooper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598459232 PECOS PAC ID: 1658734637 Enrollment ID: I20230823002765 |
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