Provider Demographics
NPI:1508382599
Name:CARLSON, JOSEPH ANDREW (LPC, LPCC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ANDREW
Last Name:CARLSON
Suffix:
Gender:M
Credentials:LPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 SHADOW MOUNTAIN DR STE E-307
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-4707
Mailing Address - Country:US
Mailing Address - Phone:713-504-2681
Mailing Address - Fax:
Practice Address - Street 1:279 SHADOW MOUNTAIN DR STE E-307
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-4707
Practice Address - Country:US
Practice Address - Phone:713-504-2681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0189461101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional