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NPI Code Detail

MEDICARE: PATRICIA LOUISE CARLSTROM LPCC

MEDICARE: PATRICIA LOUISE CARLSTROM LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4105MN

General Provider Information

NPI Number : 1154194181
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA LOUISE CARLSTROM LPCC
Provider Business Mailing Address
First Line : 2315 SCENIC POINT DR SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-2564
Country : US
Telephone Number : 507-421-0280
Fax Number :
Provider Business Practice Location Address
First Line : 1620 GREENVIEW DR SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-4319
Country : US
Telephone Number : 507-535-5614
Fax Number : 507-535-5799
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2023
Last Update Date : 11/01/2023

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Directions to “ PATRICIA LOUISE CARLSTROM LPCC” Practice Location

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