George Carlson

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

SW132824 Issued in PA

Legal business name

GEORGE CARLSON

Practice address

6068 Route 119
Punxsutawney, PA 15767

Phone

(814) 952-7103

NPI assigned

Nov 18, 2015

Organization subpart

No

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

Authorized official

Name

George Carlson, LSW

Title

Counselor

Phone

(814) 952-7103

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• george carlson counseling Former legal business name

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

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1679947378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6068 ROUTE 119",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "157674019",
            "telephone_number": "814-952-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6068 ROUTE 119",
            "city": "PUNXSUTAWNEY",
            "state": "PA",
            "postal_code": "15767",
            "telephone_number": "814-952-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE CARLSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-18",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "814-952-7103",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "PA",
            "license": "SW132824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2254",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "george carlson counseling",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• W Scott Flipse, MD
• Deborah Gavlak Freeland
• Douglas S Fugate, M.D.
• Kenneth K Fugate, M.D.
• Ashley Geist
• George R. Cherian, M.D., P.C.
• Giant Eagle, Inc
• Bethany Ann Gibbons, CRNP
• Amy Gigliotti, D.M.D.
• Bradley James Gigliotti, RPH

• All providers in Punxsutawney, PA
• Health Maintenance Organization in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.