MRS. KIMBERLY DAWN CARROLL (MA) – Professional Counselor, NPI 1225532062

MRS. KIMBERLY DAWN CARROLL (MA) is a healthcare provider. based in Clintwood, Virginia. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MA. They hold a License No. 0701007460 (VA). The NPI Number for MRS. KIMBERLY DAWN CARROLL (MA) is 1225532062

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
MRS. KIMBERLY DAWN CARROLL (MA)
NPI
1225532062
Phone
(276) 393-2367
Address
3855 DC CANEY RIDGE RD
Enumeration Date
19 March 2018
Last Update Date
19 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2762193237
Graduation Year
2014 (12 years ago)
PAC ID
0244678258
Group Practice PAC ID
6709224710
Professional Enrollment ID
I20240424000892
Address ID
VA242282030CL203XXSTXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

1,998 MENTAL HEALTH COUNSELOR in VA

Provider Addresses for MRS. KIMBERLY DAWN CARROLL (MA)

  • 3855 DC CANEY RIDGE RD

    CLINTWOOD, VA 242287861

    Phone: (276) 393-2367

    Type: Mailing

  • 220 CLAY DR

    POUNDING MILL, VA 246374320

    Phone: (276) 963-3606

    Type: Location

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: 2024-04-24

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
I20240424000892IMental Health CounselorVATBD

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 24228)

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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: 6709224710View full group profile
NameSpecialtyState
Mental Health CounselorVA
Clinical Social WorkerVA
Mental Health CounselorVA
Mental Health CounselorVA

Reviews

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Frequently asked questions

What NPI should I save for MRS. KIMBERLY DAWN CARROLL (MA)?
Save NPI 1225532062 if you need a stable reference for MRS. KIMBERLY DAWN CARROLL (MA).
Is MRS. KIMBERLY DAWN CARROLL (MA) active in the national directory?
MRS. KIMBERLY DAWN CARROLL (MA)'s public NPI profile is in an active state.
Does MRS. KIMBERLY DAWN CARROLL (MA) list a primary specialty?
If you are matching referrals, note Professional Counselor for MRS. KIMBERLY DAWN CARROLL (MA). Clinical services aligned with this taxonomy classification.
Does MRS. KIMBERLY DAWN CARROLL (MA) practice in Virginia?
You will see Clintwood, Virginia on file for MRS. KIMBERLY DAWN CARROLL (MA) alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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