Deborah Sue Carolan

Individual provider Active NPI Mental Health Counselor · Lemoore, CA

NPI 1659390953 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1659390953
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
MY013166 (CA)
Practice address
130 E Hanford Armona Rd
Suite E
Lemoore, CA 93245-2139
Phone
(559) 924-1504
Fax
(559) 924-1504
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1502 Erin Way
Hanford, CA 93230-3256

18767 King Ave
Stratford, CA 93266-9752
Phone (559) 924-1504

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251202000843 CA Practitioner - Marriage and Family Therapist 9133612807 Practice locations: Stratford, CA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MY013166CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Deborah S. Carolan MFT & Associates Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MY013166 CA Yes

Addresses

Primary practice location

130 E Hanford Armona Rd
Suite E
Lemoore, CA 93245-2139

Mailing address

130 E Hanford Armona Rd
Suite E
Lemoore, CA 93245-2139
Phone (559) 924-1504

Other identifiers

IdentifierTypeStateIssuer
ZZZ86155ZOtherCABLUE SHIELD

Other providers in Lemoore, CA

All providers in Lemoore, CA · Mental Health Counselor in California

Sources for this page

Verify at the official NPI Registry.