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General NPI Number Information
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NPI Number | 1336339944
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Entity Type | Individual
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Provider Name | GENEVIEVE RANSOM CARLSON M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2007
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 720 WOOD ST
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City | EUREKA
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State | CA
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Zip | 95501-4413
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Country | US
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Telephone | 707-268-2983
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Fax |
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Provider Business Mailing Address
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Address Line | 1813 BUTTERMILK LN
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City | ARCATA
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State | CA
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Zip | 95521-6917
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Country | US
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Telephone | 707-825-6658
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Fax | 707-825-6658
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | ASW21923
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License Number State | CA
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