Carolyn Elizabeth Mangelsdorf, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001960 Issued in WA

Practice address

23715 84TH Ave W Unit 102
Edmonds, WA 98026-9511

Phone

(206) 293-5541

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Seattle Physical Therapy Solutions LLC

  • Orthopedic Physical Therapist
  • Seattle, WA
  • NPI 1932498441
  NPD (past)

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1942407358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23715 84TH AVE W UNIT 102",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269511",
            "telephone_number": "206-293-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23715 84TH AVE W UNIT 102",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980269511",
            "telephone_number": "206-293-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGELSDORF",
        "first_name": "CAROLYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mai Pham, MD PS (Seattle Vascular Surgery)
• John D Maldazys, MD
• Gurjot Kaur Malhi, MD
• Linda Mallery, LPN
• Praveen Kumar Mambalam, M.D.
• Terra Rose Mangum, MN, ARNP
• Carolyn P Maret, LICSW
• Mary Margaret, L.M.P.
• Ashlee Marie Margheim, MD
• Anita Marie, LMP

• Clinical Psychologist in Edmonds, WA
• Providers in Edmonds, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; 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.