Provider Demographics
NPI:1649362807
Name:ARLIEN, CARLA RENAE (PHD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:RENAE
Last Name:ARLIEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5545
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-0545
Mailing Address - Country:US
Mailing Address - Phone:330-953-1354
Mailing Address - Fax:330-953-1364
Practice Address - Street 1:819 SOUTHWESTERN RUN STE 2
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3623
Practice Address - Country:US
Practice Address - Phone:330-953-1354
Practice Address - Fax:330-953-1364
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6644103G00000X, 103TC0700X
PAPS15015878103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016188470001Medicaid
OH3072455Medicaid
PA214521Medicare PIN
PAQ60081Medicare UPIN
PA1016188470001Medicaid
OHCP34801Medicare PIN