Provider Demographics
NPI:1144402603
Name:CARLSEN, DEBRA DAWN (MSW MHP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:DAWN
Last Name:CARLSEN
Suffix:
Gender:F
Credentials:MSW MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10407 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3540
Mailing Address - Country:US
Mailing Address - Phone:425-374-5610
Mailing Address - Fax:425-267-9779
Practice Address - Street 1:10407 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3540
Practice Address - Country:US
Practice Address - Phone:425-374-5610
Practice Address - Fax:425-267-9779
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61001391101YA0400X
104100000X
WACP61418908101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker