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NPI Code Detail

MEDICARE: LUCILLE CARSTENS PH.D.

MEDICARE: LUCILLE CARSTENS PH.D.
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
1103TC0700XClinical PsychologistPSY-190HI
2103TC0700XClinical Psychologist1361WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11361OTHERWASTATE LICENSE
2PSY-190OTHERHISTATE LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811935422
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCILLE CARSTENS PH.D.
Provider Business Mailing Address
First Line : 197 NW 13TH CT
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-3810
Country : US
Telephone Number : 360-675-9320
Fax Number :
Provider Business Practice Location Address
First Line : 75-5751 KUAKINI HWY
Second Line :
City : KAILUA KONA
State : HI
Zip : 96740-1705
Country : US
Telephone Number : 808-329-7176
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 07/09/2007

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Directions to “ LUCILLE CARSTENS PH.D.” Practice Location

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