Provider Demographics
NPI:1932650306
Name:CARSON, CHRISTOPHER TYLER (LMHC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:TYLER
Last Name:CARSON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BRADSHAW ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-1137
Mailing Address - Country:US
Mailing Address - Phone:857-400-0410
Mailing Address - Fax:
Practice Address - Street 1:26 BRADSHAW ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1137
Practice Address - Country:US
Practice Address - Phone:857-400-0410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health