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NPI Code Detail

MEDICARE: LADY CAROLINA PEDERSEN LMFT

MEDICARE: LADY CAROLINA PEDERSEN LMFT
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
1106H00000XMarriage & Family Therapist204460TX

General Provider Information

NPI Number : 1851100440
Entity Type Code : Individual
Provider Name (Legal Business Name) : LADY CAROLINA PEDERSEN LMFT
Provider Business Mailing Address
First Line : 6726 LANCRET HILL DR APT B
Second Line :
City : AUSTIN
State : TX
Zip : 78745-4717
Country : US
Telephone Number : 786-319-3418
Fax Number :
Provider Business Practice Location Address
First Line : 8956 RESEARCH BLVD BLDG 2
Second Line :
City : AUSTIN
State : TX
Zip : 78758-5969
Country : US
Telephone Number : 512-451-7337
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 12/19/2025

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Directions to “ LADY CAROLINA PEDERSEN LMFT” Practice Location

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