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General NPI Number Information
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NPI Number | 1932775418
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Entity Type | Individual
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Provider Name | JASMINE N CARLSON MS, LPC
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Gender | Female
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 454 1/2 SUNSET LN
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City | PUEBLO
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State | CO
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Zip | 81005-1190
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Country | US
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Telephone | 719-557-0415
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Fax |
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Provider Business Mailing Address
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Address Line | 8964 PUEBLO MOUNTAIN PARK RD
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City | BEULAH
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State | CO
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Zip | 81023-9706
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Country | US
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Telephone | 719-557-0415
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC.0021406
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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