Provider Demographics
NPI:1972999258
Name:CARLSON, NAPHTALI (LMHC)
Entity type:Individual
Prefix:
First Name:NAPHTALI
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LMHC
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 3023
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98046-3023
Mailing Address - Country:US
Mailing Address - Phone:425-820-4717
Mailing Address - Fax:425-354-5604
Practice Address - Street 1:817 238TH ST SE STE H
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-4309
Practice Address - Country:US
Practice Address - Phone:425-820-4717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60754374175T00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist