Provider Demographics
NPI:1649201021
Name:CARBO, JOHN P (LMFT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:CARBO
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ALPHA AVENUE
Mailing Address - Street 2:
Mailing Address - City:STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06378-1115
Mailing Address - Country:US
Mailing Address - Phone:860-535-7210
Mailing Address - Fax:
Practice Address - Street 1:65 ALPHA AVE
Practice Address - Street 2:
Practice Address - City:STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06378-1115
Practice Address - Country:US
Practice Address - Phone:860-535-7210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000569106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000569OtherMARRIAGE/FAMILY THERAPIST
MA976OtherMARRIAGE/FAMILY THERAPIST