Provider Demographics
NPI:1174946685
Name:CARLSON, MARGARET (MEG) (LPCC)
Entity type:Individual
Prefix:
First Name:MARGARET (MEG)
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 RANCH DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-2572
Mailing Address - Country:US
Mailing Address - Phone:505-259-1574
Mailing Address - Fax:
Practice Address - Street 1:2100 RANCH DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2572
Practice Address - Country:US
Practice Address - Phone:505-259-1574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0161051101YM0800X
NMCCMH1097121101YM0800X
CCMH0197121101YP2500X
NMCAT0197131221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional