Active NPI
Carol Carlson, PHD
- Psychologist
- Latham, NY
National Provider Identifier
1861572729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 015227-01
- Practice address
- 20 Century Hill Drive
Suite 202
Latham, NY 12110 - Phone
- (518) 785-7283
- Fax
- (518) 785-7293
- NPI assigned
- Oct 16, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 015227-01 | NY | Primary |
Addresses
Primary practice location
20 Century Hill Drive
Suite 202
Latham, NY 12110
Mailing address
15 Fordham CT
Albany, NY 12209-1109
Phone (518) 810-5145
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
20 Century Hill Dr
Suite 202
Latham, NY 12110-2198
Phone (518) 785-7283
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015227-01 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Health Specialists, PLLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Clinical Psychologist
- Latham, NY
- NPI 1215152962
-
- Clinical Social Worker
- Latham, NY
- NPI 1992809016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861572729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 FORDHAM CT",
"city": "ALBANY",
"state": "NY",
"postal_code": "122091109",
"telephone_number": "518-810-5145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CENTURY HILL DRIVE",
"address_2": "SUITE 202",
"city": "LATHAM",
"state": "NY",
"postal_code": "12110",
"telephone_number": "518-785-7283",
"fax_number": "518-785-7293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "CAROL",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "015227-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Latham, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.