Active NPI
Jan Carlson, L.P.C.
- Mental Health Counselor
- Austin, TX
National Provider Identifier
1891901310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 09019
- Practice address
- 504 W 17TH St
Austin, TX 78701-1203 - Phone
- (512) 306-1488
- NPI assigned
- May 14, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 09019 | TX | Primary |
Addresses
Primary practice location
504 W 17TH St
Austin, TX 78701-1203
Mailing address
4907 Summerset TRL
Austin, TX 78749-1329
Phone (512) 306-1488
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09019 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200700800000",
"number": "1891901310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4907 SUMMERSET TRL",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787491329",
"telephone_number": "512-306-1488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 W 17TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787011203",
"telephone_number": "512-306-1488"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARLSON",
"first_name": "JAN",
"name_prefix": "Ms.",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2008-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "09019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.