Provider Demographics
NPI:1255912606
Name:CARLSON, FAITH (MS, LCPC)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E JOPPA RD STE 402
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-3109
Mailing Address - Country:US
Mailing Address - Phone:410-978-7283
Mailing Address - Fax:
Practice Address - Street 1:200 E JOPPA RD STE 402
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-3109
Practice Address - Country:US
Practice Address - Phone:410-978-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-17
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10398101YP2500X
MDLC12549101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional