KACIE D CARROLL – Mental Health Counselor, NPI 1811258809

KACIE D CARROLL is a healthcare provider. based in Fort smith, Arkansas. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. P2207005 (AR). The NPI Number for KACIE D CARROLL is 1811258809

Main info

Female
9 Years Of Experience
Name
KACIE D CARROLL
NPI
1811258809
Phone
(479) 452-5040
Address
1340 S Waldron Rd
Enumeration Date
6 June 2012
Last Update Date
19 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4798316007
Graduation Year
2017 (9 years ago)
PAC ID
5294184875
Group Practice PAC ID
8527373232
Professional Enrollment ID
I20231207002308
Address ID
AR729036167FO7217XDRXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:14State licenses:1Digital endpointsOther names

640 MENTAL HEALTH COUNSELOR in AR

Provider Addresses for KACIE D CARROLL

  • 1340 S Waldron Rd

    Fort Smith, AR 729032556

    Phone: (479) 452-5040

    Fax: (479) 452-5047

    Type: Location

  • 7217 CAMERON PARK DR

    FORT SMITH, AR 729036167

    Phone: (479) 831-6007

    Fax: (479) 782-1242

    Type: Location

  • 1340 S WALDRON RD

    FORT SMITH, AR 729032556

    Phone: (479) 452-5040

    Fax: (479) 452-5047

    Type: Location

  • PO BOX 23070

    BARLING, AR 729230070

    Phone: (479) 452-5040

    Fax: (479) 452-5047

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-12-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20231207002308IMental Health CounselorARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 72903)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527373232View full group profile
NameSpecialtyState
P S Y C H I A T R YAR
P S Y C H I A T R YAR
Mental Health CounselorAR
Nurse PractitionerAR
Mental Health CounselorAR
Nurse PractitionerAR
Mental Health CounselorAR
-AR
Nurse PractitionerAR
Nurse PractitionerAR

Reviews

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Frequently asked questions

What is the registry number for KACIE D CARROLL?
The registry entry for KACIE D CARROLL shows NPI 1811258809.
Does the public listing show KACIE D CARROLL as active?
KACIE D CARROLL's NPI record reflects an active status in NPPES.
What services align with KACIE D CARROLL's listing?
KACIE D CARROLL's public classification highlights Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Can patients visit KACIE D CARROLL in Fort Smith, Arkansas?
For routing, start with Fort Smith, Arkansas for KACIE D CARROLL, then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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