Provider Demographics
NPI:1336622984
Name:RINALDI, CARLA MARIE (LAC)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:MARIE
Last Name:RINALDI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WILSON AVE APT B
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-1494
Mailing Address - Country:US
Mailing Address - Phone:614-906-6922
Mailing Address - Fax:
Practice Address - Street 1:133 WILSON AVE APT B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-1494
Practice Address - Country:US
Practice Address - Phone:614-906-6922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 171M00000X
OH65.000335171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171100000XOther Service ProvidersAcupuncturist