Provider Demographics
NPI:1346835519
Name:CARLSON COUNSELING & PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:CARLSON COUNSELING & PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, MSW
Authorized Official - Phone:317-406-8306
Mailing Address - Street 1:59 BAYSHORE CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3901
Mailing Address - Country:US
Mailing Address - Phone:317-406-8306
Mailing Address - Fax:317-406-8306
Practice Address - Street 1:59 BAYSHORE CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-3901
Practice Address - Country:US
Practice Address - Phone:317-406-8306
Practice Address - Fax:317-406-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty