Provider Demographics
NPI:1649003435
Name:CARLSON-STEVENSON, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:CARLSON-STEVENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:CARLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2397
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58802-2397
Mailing Address - Country:US
Mailing Address - Phone:701-572-6757
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2397
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58802-2397
Practice Address - Country:US
Practice Address - Phone:701-572-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND423302103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool