Connie Mae Carlson, L.M.F.T

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1051 Issued in MN

Practice address

1555 Bender Rd
Chaska, MN 55318-2613

Phone

(612) 616-6113

NPI assigned

Dec 20, 2011

Last updated

Dec 20, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1629347653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 BENDER RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182613",
            "telephone_number": "612-616-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 BENDER RD",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182613",
            "telephone_number": "612-616-6113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CONNIE",
        "middle_name": "MAE",
        "name_prefix": "Miss",
        "credential": "L.M.F.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-20",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Caballero
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• Armani S Cartlidge, MA, LPCC
• Carver County (Carver County Public Health)
• Carver County (Carver County Health and Human Services)
• Emma Cavanaugh-Johnson
• Vanessa Centeno

• Marriage & Family Therapist in Chaska, MN
• Providers in Chaska, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.