Carlisle E Bergquist, LCMFT
Individual provider Active NPI Marriage & Family Therapist · Salina, KS
NPI 1881767549 · NPPES record last updated Dec 1, 2007
Key facts
- NPI
- 1881767549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 169 (KS)
- Practice address
- 901 W South St
Salina, KS 67401-4053 - Phone
- (785) 827-1835
- Fax
- (785) 493-8008
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31113 | CA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 169 | KS | Yes |
| Marriage & Family Therapist | 106H00000X | 31113 | CA |
Addresses
Primary practice location
901 W South St
Salina, KS 67401-4053
Mailing address
901 W South St
Salina, KS 67401-4053
Phone (785) 827-1835
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 31113 | Other | CA | LMFT |
| 169 | Other | KS | LCMFT |
Other providers in Salina, KS
- Mark G Bell
- Karil L Bellah
- Andrea Bellassai
- Debra Bengston
- Daniel A Berg
- Tamara R Bernard
- Kent B. Berquist
- Lisa Berry
- Kraig Edward Bertram II
- Crystal Ann Bertrand
All providers in Salina, KS · Marriage & Family Therapist in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.