Provider Demographics
NPI:1518391580
Name:LLOYD, CARLETON H (PHD, PSYD)
Entity Type:Individual
Prefix:DR
First Name:CARLETON
Middle Name:H
Last Name:LLOYD
Suffix:
Gender:M
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 VERMILLION ST
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1739
Mailing Address - Country:US
Mailing Address - Phone:503-538-6674
Mailing Address - Fax:
Practice Address - Street 1:915 VERMILLION ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1739
Practice Address - Country:US
Practice Address - Phone:503-538-6674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCDC 619101YA0400X
OR508697101YA0400X
TXLPC 9276101YM0800X
ORC6430101YM0800X, 101YP2500X
TXLMSW 162711041C0700X
TXLMFT 580-574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist