Provider Demographics
NPI:1881722692
Name:CARLSON, GINGER APLING (PHD)
Entity type:Individual
Prefix:DR
First Name:GINGER
Middle Name:APLING
Last Name:CARLSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:GINGER
Other - Middle Name:C
Other - Last Name:APLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1919 E THOMAS RD
Mailing Address - Street 2:BUILDING 2108, SUITE 101
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7710
Mailing Address - Country:US
Mailing Address - Phone:602-512-8029
Mailing Address - Fax:602-512-8161
Practice Address - Street 1:5131 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2799
Practice Address - Country:US
Practice Address - Phone:480-833-5437
Practice Address - Fax:480-833-9349
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3851103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ398983OtherMHN