Penny Carlson, M.S. LPC SUPERVISED

Individual provider Active NPI Mental Health Counselor · Altus, OK

NPI 1811320906 · NPPES record last updated Jan 3, 2014

Key facts

NPI
1811320906
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
317 N Hudson St
Altus, OK 73521-3709
Phone
(580) 482-2809
Fax
(580) 482-2820
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

317 N Hudson St
Altus, OK 73521-3709

Mailing address

319 N Hudson St
Altus, OK 73521-3709

Other providers in Altus, OK

All providers in Altus, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.