Provider Demographics
NPI:1023078474
Name:CARLSON, CHARLOTTE A (LPC)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:A
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5213
Mailing Address - Country:US
Mailing Address - Phone:501-664-9050
Mailing Address - Fax:501-296-9323
Practice Address - Street 1:100 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5213
Practice Address - Country:US
Practice Address - Phone:501-664-9050
Practice Address - Fax:501-296-9323
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8108207101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional