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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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 1750523189 NPPES
Iowa MEDICAID 600661039

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