HEATHER CARROLL (NPI# 1346649688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346649688 |
| Entity Type | Individual |
| Full Name | HEATHER CARROLL |
| Other Name | HEATHER WARRELL |
| Credential | COTA |
| Practice Address |
430 E Cleveland Rd Granger IN 46530-5624 |
| Mailing Address |
19839 Dice St South Bend IN 46614-5513 |
| Practice Telephone | 5742713305 |
| Mailing Telephone | 5742172213 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | COTA | 32001597A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912497165 | Heather Jo Carroll | Occupational Therapist | 5021 Mercer University Dr Ste D2, Macon, GA 31210-6228 | 2018-05-14 |
| 1902246689 | Heather Elizabeth Carroll | Internal Medicine | 4100 Park Forest Dr Ste 208, Traverse City, MI 49684-7306 | 2013-06-26 |
| 1912033101 | Heather Carroll | Massage Therapist | 1241 E River Rd, Avon, NY 14414-9539 | 2007-02-24 |
| 1396301826 | Heather Elizabeth Carroll | Counselor | 1400 N Johnson Ave Ste 101, El Cajon, CA 92020-1651 | 2019-05-09 |
| 1891239414 | Heather Carroll | Social Worker | 287 Middlesex Ave, Medford, MA 02155-5056 | 2016-12-16 |
| 1023550704 | Heather Nicole Carroll | Nurse Practitioner | 75 Pringle Way, Suite 512, Reno, NV 89502-1464 | 2016-11-10 |
| 1366802209 | Heather Carroll | Psychologist | 2075 W Big Beaver Rd, Suite 520, Troy, MI 48084-3407 | 2016-03-04 |
| 1689071367 | Heather Colleen Carroll | Specialist/Technologist | 2937 S Brentwood Blvd, Brentwood, MO 63144-2713 | 2014-11-25 |
| 1750661260 | Heather Carroll | Nurse Practitioner | 140 Main St, Prospect Hill, NC 27314-9436 | 2011-08-29 |
| 1376853184 | Heather Anne Carroll | Occupational Therapist | 1008 Hwy 25 B, Heber Springs, AR 72543 | 2010-10-14 |
| Street Address |
430 E CLEVELAND RD |
| City | GRANGER |
| State | IN |
| Zip Code | 46530-5624 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336475300 | Emeritus Corporation | Alzheimer Center (Dementia Center) | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2009-10-27 |
| 1043605553 | Abby Weber | Occupational Therapy Assistant | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2015-04-01 |
| 1093116121 | Lauren Clevenger | Occupational Therapist | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2014-09-08 |
| 1831503952 | Legacy Healthcare Services, Inc | Occupational Therapist | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2014-06-17 |
| 1922374099 | Jeanette Josol Jumao-as | Physical Therapist | 430 E Cleveland Rd, Granger, IN 46530-5624 | 2012-03-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821610783 | Michiana Weight Loss and Wellness Clinic LLC | Internal Medicine | 14304 Sr 23, Granger, IN 46530 | 2020-05-14 |
| 1609427921 | Stephen J Armet | Physical Therapist | 16733 Saratoga Ct, Granger, IN 46530 | 2019-09-27 |
| 1881177756 | Memorial Hospital of South Bend | General Acute Care Hospital | 3220 Beacon Parkway, Granger, IN 46530 | 2018-09-07 |
| 1922483635 | Kiley Ramer | Behavioral Analyst | 6910 N Main St Bldg 13c51, Granger, IN 46530 | 2015-07-23 |
| 1326439415 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 625 E University Dr., Granger, IN 46530 | 2015-02-10 |
| 1811302094 | Costco Wholesale Corporation | Pharmacy | 625 E. University Drive, Granger, IN 46530 | 2014-06-25 |
| 1255773255 | Tracy Joyce Abel | Behavioral Analyst | 12042 Covered Wagon Court, Granger, IN 46530 | 2013-07-19 |
| 1225376304 | George Youssef | Internal Medicine | 5610 Town Center Drive #14, Granger, IN 46530 | 2013-01-23 |
| 1033489596 | Rene Raul Arce Guarnaluse | Homeopath | Emilio Bayarri 50, Puzol, VALENCIA 46530 | 2011-12-30 |
| 1568747368 | Ranya Bouzou-kadi | Pharmacist | 13060 Adams, Granger, IN 46530 | 2011-10-13 |
| Find all providers in zip 46530 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891274882 | Wow Factor Winning Options In Wellness | Assisted Living Facility | 301 Hamlin St, Gary, IN 46406-1338 | 2018-08-09 |
| 1790994796 | Capitol City Residential Health Care LLC | Assisted Living Facility | 1608 E 10th St, Indianapolis, IN 46201-1902 | 2007-05-22 |
| 1205315033 | Michiana Mental Health Care, LLC. | Assisted Living Facility | 210 S Race St, Mishawaka, IN 46544 | 2018-08-13 |
| 1285038703 | Oluseye Lawal | Assisted Living Facility | 1100 W 6th Ave, Gary, IN 46402-1711 | 2014-10-13 |
| 1407919806 | Home Med Pharmacy LLC | Assisted Living Facility | 6210 Technology Center Dr, Indianapolis, IN 46278 | 2006-12-18 |
Please comment or provide details below to improve the information on HEATHER CARROLL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.