Provider Demographics
NPI:1619743119
Name:CARLSON, MELANIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 DORIC DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-1212
Mailing Address - Country:US
Mailing Address - Phone:303-926-9998
Mailing Address - Fax:
Practice Address - Street 1:698 BRIGGS ST.
Practice Address - Street 2:SUITE 4
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516
Practice Address - Country:US
Practice Address - Phone:551-280-0264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0019968101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor