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CLARK CARROLL APNP
NPI 1962773648
Nurse Practitioner - Psychiatric/Mental Health in Janesville, WI

Active since January 26, 2012
1820 CENTER AVE STE 170, JANESVILLE, WI 53546(608) 755-1475(608) 755-1733 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 1, 2021, May 1, 2019 (2 updates tracked since 2019).

About Clark Carroll Apnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARK CARROLL APNP (NPI 1962773648) is an individual psychiatric/mental health provider in Janesville, Wisconsin, licensed in Wisconsin (7914) and active in the NPI registry since January 2012. He maintains a secondary practice location in Madison.

NPPES Registry Identity

NPI1962773648
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameCLARK CARROLLCredential: APNP
Location Address1820 CENTER AVE STE 170Janesville, WI 53546-2878
Mailing Address203 W Sunny LnJanesville, WI 53546-9091 · (608) 755-1475 · Fax (608) 755-1733
Phone(608) 755-1475
Fax(608) 755-1733
Sole ProprietorNo
Enumeration DateJanuary 26, 2012
Last NPPES UpdateMarch 1, 20212 updates tracked since enumeration
NPPES CertifiedMarch 1, 2021
✔ NPI 1962773648 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in WI · 7914
1820 CENTER AVE STE 170, Janesville, WI 53546
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Other Names 1

Other Name (5)Clark T. Carroll

Secondary Practice Location 1

Location 1625 W Washington AveMadison, WI 53703-2637 · Phone (608) 280-2700

Other Identifiers 1

Medicaid1962773648WI

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROCK VALLEY COMMUNITY PROGRAMS, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
1820 CENTER AVE STE 170
JANESVILLE, WI 53546
Rock County (608) 755-1475
BETSY L REED LCSW
Social Worker
1820 CENTER AVE STE 170
JANESVILLE, WI 53546
Rock County (608) 755-1475
MARY PINTARRO APNP
Nurse Practitioner (Psychiatric/Mental Health)
1820 CENTER AVE STE 170
JANESVILLE, WI 53546
Rock County (608) 755-1475

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clark Carroll's NPI number?

The NPI number for Clark Carroll is 1962773648. It was assigned to this individual provider in the NPPES registry on January 26, 2012. The provider is also known as Clark T. Carroll.

Where is Clark Carroll located?

Clark Carroll practices at 1820 Center Ave Ste 170, Janesville, WI 53546. The listed phone number is (608) 755-1475.

What is Clark Carroll's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Clark Carroll was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.