Carlson, John D
Carlson, John D is an individual health care provider with primary practice located at 221 3Rd St W , Jbsa Randolph TX 78150-4800. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Carlson, John D can be contacted via phone (210) 652-6403.Contact Information
Primary practice address
221 3Rd St W
Jbsa Randolph TX 78150-4800
Phone: (210) 652-6403
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 757 | Nebraska |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1373 | Nebraska |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 06798 | Iowa |
Profile Details
| NPI number | 1750523189 |
|---|---|
| LBN Legal business name | Carlson, John D |
| Credentials | MSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2009 |
| Last updated | Sep 22nd, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750523189 | NPPES |
| Iowa | MEDICAID | 600661039 |
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