Provider Demographics
NPI:1104577618
Name:CARROLL, MARGARET
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:CARROLL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 318
Mailing Address - Street 2:
Mailing Address - City:YORKLYN
Mailing Address - State:DE
Mailing Address - Zip Code:19736-0318
Mailing Address - Country:US
Mailing Address - Phone:302-753-9068
Mailing Address - Fax:
Practice Address - Street 1:524 N PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-3056
Practice Address - Country:US
Practice Address - Phone:484-440-9416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAPC018420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program