Active NPI
Carl Samuel Carlson, M.S., LPES
- School Psychologist
- Fort Mill, SC
National Provider Identifier
1386956464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4579
- Practice address
- 1171 Market St
Suite 103
Fort Mill, SC 29708-6500 - Phone
- (704) 641-8902
- NPI assigned
- Jul 6, 2010
- Last updated
- Jul 6, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4579 | SC | Primary |
Addresses
Primary practice location
1171 Market St
Suite 103
Fort Mill, SC 29708-6500
Mailing address
1171 Market St
Suite 103
Fort Mill, SC 29708-6500
Phone (704) 641-8902
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4579 | SC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278374400000",
"number": "1386956464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1171 MARKET ST",
"address_2": "SUITE 103",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297086500",
"telephone_number": "704-641-8902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1171 MARKET ST",
"address_2": "SUITE 103",
"city": "FORT MILL",
"state": "SC",
"postal_code": "297086500",
"telephone_number": "704-641-8902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "CARL",
"middle_name": "SAMUEL",
"credential": "M.S., LPES",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-07-06",
"last_updated": "2010-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "SC",
"license": "4579",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mill, SC
- Patience Canty, DC
- Carebuddy Upstate SC LLC
- Tiffany Nicole Carey
- Caring Seasons Health, LLC (Caring Seasons Health South Carolina)
- Caring Seasons Health, LLC
- Krystal Kayla Carmichael, MD
- Carolina Community Counseling LLC
- Carolina Community Maternity Center
- Carolina Community Maternity Center
- Carolina Endocrinology & Diabetes, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.