Heather Elizabeth Carlson

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

107469-01 Issued in NY

Practice address

200 E 3Rd St
Jamestown, NY 14701-5433

Phone

(716) 661-8330

Fax

(716) 661-8364

NPI assigned

Jul 3, 2017

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Chautauqua - a Mun Corp

  dba Chautauqua County Department of Mental Hygiene

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, NY
  • NPI 1902897374
  NPD (past)

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1619498482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ACADEMY ST",
            "city": "MAYVILLE",
            "state": "NY",
            "postal_code": "147571033",
            "telephone_number": "716-753-4104",
            "fax_number": "716-753-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E 3RD ST",
            "city": "JAMESTOWN",
            "state": "NY",
            "postal_code": "147015433",
            "telephone_number": "716-661-8330",
            "fax_number": "716-661-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "HEATHER",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "107469-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Joseph Carcione, BS
• Mathew A Cardinale
• David Gordon Carlberg, RPH
• Andrea J Carlson, LPN
• Erin Carlson
• Lyndsey Marie Carlson, RPA-C
• Michelle Carlson
• Trisha M Carlson, NP
• Maryellen Carlucci
• Brendan Carter, PTA

• Mental Health Counselor in Jamestown, NY
• Providers in Jamestown, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; 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.