DIANA CARLSON (NPI# 1023441920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023441920 |
| Entity Type | Individual |
| Full Name | DIANA CARLSON |
| Credential | MA |
| Practice Address |
4804 Lacey Blvd Se Ste A Lacey WA 98503-5733 |
| Mailing Address |
950 Ebbets Dr Sw Tumwater WA 98512-4609 |
| Practice Telephone | 3607995782 |
| Practice Fax Number | 3605391715 |
| Mailing Telephone | 3609709295 |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2019-06-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
WA | Behavioral Health & Social Service Providers | |
| Y | 106H00000X | Marriage & Family Therapist | 60969570 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558307843 | Diana Gouveia Carlson | Social Worker | 21 Glen Ave, Suite 3, Chelmsford, MA 01824-2858 | 2006-06-22 |
| 1689825564 | Diana Jolynn Carlson | Internal Medicine | 100 N Pond Dr, Suite C, Walled Lake, MI 48390-3079 | 2008-10-09 |
| Street Address |
4804 LACEY BLVD SE STE A |
| City | LACEY |
| State | WA |
| Zip Code | 98503-5733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306004775 | Pathways Mental Health Services | Clinic/Center | 4804 Lacey Blvd Se Ste A, Suite C-3, Lacey, WA 98503-5733 | 2008-06-01 |
| 1750916086 | Ozark Gore | Psychologist | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2020-03-06 |
| 1255970554 | Elaine Vaughn | Counselor | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2020-01-03 |
| 1649830647 | Jeremy Craig Bolden | Social Worker | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2019-06-20 |
| 1821555111 | Katherine Eleanor Parker | Marriage & Family Therapist | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2019-02-22 |
| 1053822502 | Megan E Plascencia | Counselor | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2017-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457838989 | Michele Nordgren Bourque | Psychologist | 4329 Concordia Lane Se, Lacey, WA 98503 | 2018-07-26 |
| 1831638675 | Trevor John Marum | Chiropractor | 3945 8th Ave Se, Lacey, WA 98503 | 2017-02-13 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1144683616 | Millenda Thomas | Registered Nurse | 1233 Firpark Dr. S.e., Lacey, WA 98503 | 2016-04-01 |
| 1609257245 | Erika Charlotte Vonkotzebue | Counselor | 4401 37th Ave. Se #25, Lacey, WA 98503 | 2015-06-09 |
| 1437576196 | Candy Nelson | Registered Nurse | 4410 6th Ave Se, Apt# 115, Lacy, WA 98503 | 2014-03-19 |
| 1134563919 | Alvin Fitzgerald | Pharmacist | 665 Sleater Kinney Rd., S.e, Target Pharmacy #1355, Lacey, WA 98503 | 2013-04-23 |
| 1518200724 | Katherine Mary Marsh | Psychologist | 5191 Corporate Center Court Se, Lacey, WA 98503 | 2013-04-05 |
| 1740530906 | Leanna Marie Mcbroom | Massage Therapist | 1608 Diamond Loop Se, Lacey, WA 98503 | 2012-09-14 |
| 1831445196 | Joyce Emily Christensen Coniff | Counselor | 5706 39th Ave Se., Lacey, WA 98503 | 2012-07-24 |
| Find all providers in zip 98503 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790231108 | Yoshie Wong | Marriage & Family Therapist | 673 Woodland Square Loop Se Ste 330, Lacey, WA 98503-1066 | 2016-08-27 |
| 1447678511 | Betsy Hicks | Marriage & Family Therapist | 677 Woodland Square Loop Se Ste 15, Lacey, WA 98503-1000 | 2014-04-04 |
| 1215266309 | Michael Dwayne Roos | Marriage & Family Therapist | 719 Sleater Kinney Rd Se Ste 212, Lacey, WA 98503-1138 | 2009-12-18 |
| 1982896973 | Kristiann Danielle Smith | Marriage & Family Therapist | 1145 Mountain Aire Dr Se, Lacey, WA 98503-1903 | 2007-08-14 |
| 1619094133 | George T. Mitchell | Marriage & Family Therapist | 7300 36th Ct Se, Lacey, WA 98503-3994 | 2007-03-22 |
| 1821555111 | Katherine Eleanor Parker | Marriage & Family Therapist | 4804 Lacey Blvd Se Ste A, Lacey, WA 98503-5733 | 2019-02-22 |
| 1790195980 | Sara A. Morgan | Marriage & Family Therapist | 677 Woodland Square Loop Se, Lacey, WA 98503-1000 | 2014-04-28 |
| 1215288956 | Amber Kay Jaworski | Marriage & Family Therapist | 669 Woodland Square Loop Se, Lacey, WA 98503-1038 | 2012-09-20 |
| 1083944318 | Holly M Blue | Marriage & Family Therapist | 677 Woodland Square Loop Se, #a - 4, Lacey, WA 98503-1000 | 2010-01-08 |
| 1184775918 | Heather J Johnson | Marriage & Family Therapist | 677 Woodland Square Loop Se, Suite 1 & 4, Lacey, WA 98503-1000 | 2007-01-16 |
| Find all providers in LACEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.