Timothy J Carson, BS

Individual provider Active NPI Mental Health Counselor · Logansport, IN

NPI 1962843490 · NPPES record last updated Jul 12, 2013

Key facts

NPI
1962843490
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1015 Michigan Ave
Logansport, IN 46947-1526
Phone
(574) 722-5151
Fax
(574) 735-2563
NPI assigned
Jul 12, 2013
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
Credentials
Bachelor of Science

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1015 Michigan Ave
Logansport, IN 46947-1526

Mailing address

1015 Michigan Ave
Logansport, IN 46947-1526
Phone (574) 722-5151

Other providers in Logansport, IN

All providers in Logansport, IN · Mental Health Counselor in Indiana

Sources for this page

Verify at the official NPI Registry.