Provider Demographics
NPI:1609029313
Name:CARLSON, KATRIN WOODWORTH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATRIN
Middle Name:WOODWORTH
Last Name:CARLSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 MAIN ST
Mailing Address - Street 2:BEHAVIORAL HEALTH ASSOCIATES
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-1952
Mailing Address - Country:US
Mailing Address - Phone:413-636-8653
Mailing Address - Fax:
Practice Address - Street 1:384 MAIN ST
Practice Address - Street 2:BEHAVIORAL HEALTH ASSOCIATES
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1952
Practice Address - Country:US
Practice Address - Phone:413-636-8653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-25
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8889103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical