Roberta J Carlson, MS, LMFT, LSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

828-124 Issued in WI

Practice address

100 Polk County PLZ
Suite 50
Balsam Lake, WI 54810-9071

Phone

(715) 485-8465

Fax

(715) 485-8490

NPI assigned

Apr 30, 2009

Last updated

Jan 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1241049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485388800000",
    "number": "1033353289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25806 W BASS LAKE RD",
            "city": "WEBSTER",
            "state": "WI",
            "postal_code": "548938637",
            "telephone_number": "715-866-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POLK COUNTY PLZ",
            "address_2": "SUITE 50",
            "city": "BALSAM LAKE",
            "state": "WI",
            "postal_code": "548109071",
            "telephone_number": "715-485-8465",
            "fax_number": "715-485-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ROBERTA",
        "middle_name": "J",
        "credential": "MS, LMFT, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-30",
        "last_updated": "2017-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "828-124",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9945-120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalli Bittner
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• Heather Christine Bonetti, MA, LPC
• Norma J Buck, MSE CSW
• Linda A Buschman, MS
• Nancy J Christie, BA
• Kathleen S Clark, LSW
• Elizabeth Frances Ebensperger, PHARMD
• Gary P Ehrich, CSAC, ICS
• Endeavors Adult Development Center

• Mental Health Counselor in Balsam Lake, WI
• Providers in Balsam Lake, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.