Carlson, Mark

Carlson, Mark is an individual health care provider with primary practice located at 7066 Stillwater Blvd N , Oakdale MN 55128-3937. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Carlson, Mark can be contacted via phone (651) 777-5222.

Contact Information

Primary practice address
7066 Stillwater Blvd N Oakdale MN 55128-3937
Phone: (651) 777-5222
Fax: (651) 251-5111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2212 Minnesota

Profile Details

NPI number 1790708840
LBN Legal business name Carlson, Mark
Credentials PH.D., LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jul 8th, 2007 - about 19 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 1790708840 NPPES
Minnesota Other 106227 UC
Minnesota Other 570003 UC
Minnesota Other 242966 UC
Minnesota Other 0G040CA UC
Minnesota Other 17577 UC
Minnesota Other 61-20016 UC

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