Carlson, Diane M
Carlson, Diane M is an individual health care provider with primary practice located at 1449 Old Waterbury Rd. Suite 204, Southbury CT 06488. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Carlson, Diane M can be contacted via phone (914) 419-2717.Contact Information
Primary practice address
1449 Old Waterbury Rd. Suite 204
Southbury CT 06488
Phone: (914) 419-2717
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 006495 | Connecticut |
Profile Details
| NPI number | 1417186958 |
|---|---|
| LBN Legal business name | Carlson, Diane M |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2009 |
| Last updated | Jun 10th, 2022 - 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 | 1417186958 | NPPES |
| Connecticut | Other | 006495 | CONNECTICUT STATE LICENSE |
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