Provider Demographics
NPI:1447563838
Name:DEBORAH S. CAROLAN MFT & ASSOCIATES
Entity Type:Organization
Organization Name:DEBORAH S. CAROLAN MFT & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDEPENDENT PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:CAROLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:559-924-1504
Mailing Address - Street 1:130 E HANFORD ARMONA RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2255
Mailing Address - Country:US
Mailing Address - Phone:559-924-1504
Mailing Address - Fax:559-924-1504
Practice Address - Street 1:130 E HANFORD ARMONA RD
Practice Address - Street 2:SUITE E
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2255
Practice Address - Country:US
Practice Address - Phone:559-924-1504
Practice Address - Fax:559-924-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS26464251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health