MEDICARE: CLAIRE CARPENTER

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
1	101YM0800X	Mental Health Counselor	23248

General Provider Information

NPI Number	:	1326743782
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAIRE CARPENTER

Provider Business Mailing Address
First Line	:	619 PARK AVE
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-3762
Country	:	US
Telephone Number	:	507-380-9328
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 PARK AVE
Second Line	:
City	:	NORTH MANKATO
State	:	MN
Zip	:	56003-3762
Country	:	US
Telephone Number	:	507-380-9328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2023
Last Update Date	:	04/04/2023

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Directions to “ CLAIRE CARPENTER ” Practice Location

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