Healthcare Provider Details

I. General information

NPI: 1578608311
Provider Name (Legal Business Name): JONNA GAIL CARSON-WEBB PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 04/26/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4313 6TH AVE SE STE C
LACEY WA
98503-1072
US

IV. Provider business mailing address

PO BOX 3431
LACEY WA
98509-3431
US

V. Phone/Fax

Practice location:
  • Phone: 423-892-1795
  • Fax: 423-414-2979
Mailing address:
  • Phone: 423-892-1795
  • Fax: 423-414-2979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1986
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1986
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: