Carson, Kimi
Carson, Kimi is an individual health care provider with primary practice located at 75 Kings Highway Cutoff 5Th Floor, Fairfield CT 06824-5340. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Clinical Neuropsychologist is her primary health care specialty. Carson, Kimi can be contacted via phone (203) 333-1133.Contact Information
Primary practice address
75 Kings Highway Cutoff 5Th Floor
Fairfield CT 06824-5340
Phone: (203) 333-1133
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 002599 | Connecticut |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 002599 | Connecticut |
Profile Details
| NPI number | 1518925262 |
|---|---|
| LBN Legal business name | Carson, Kimi |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Aug 1st, 2008 - about 18 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 | 1518925262 | NPPES |
| Connecticut | Other | 060002599CT01 | ANTHEM BLUE CROSS AND BLU |
| Connecticut | MEDICAID | 004248218 | ANTHEM BLUE CROSS AND BLU |
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