Carlson, Carolyn

Carlson, Carolyn is an individual health care provider with primary practice located at 149 W Cornwall Rd , Sharon CT 06069-2105. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Carlson, Carolyn can be contacted via phone (860) 672-6689.

Contact Information

Primary practice address
149 W Cornwall Rd Sharon CT 06069-2105
Fax: (860) 672-3021
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000052 Connecticut

Profile Details

NPI number 1568521235
LBN Legal business name Carlson, Carolyn
Credentials M.ED., LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2006
Last updated Jan 10th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568521235 NPPES
Connecticut MEDICAID 004257516

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