Diana Carlson, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

60969570 Issued in WA

Practice address

950 Ebbets Dr SW
Tumwater, WA 98512-4609

Phone

(360) 515-2888

NPI assigned

Aug 14, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pathways Mental Health Services

  • Mental Health Counselor
  • Olympia, WA
  • NPI 1306004775
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1023441920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 EBBETS DR SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985124609",
            "telephone_number": "360-515-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 EBBETS DR SW",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985124609",
            "telephone_number": "360-515-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "DIANA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "60969570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joni Cagwin
• Amanda Jean Callahan
• Debra L Campbell, PA-C
• Capital Medical Center Physicians LLC
• Matthew Stuart Carey, PA-C
• Randall James Carpio Jr.
• Gabriela Carranza
• Gracelin Meline Carrell, RN
• Ellyne Carrillo
• Kerry Carroll, NP

• Marriage & Family Therapist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.