Provider Demographics
NPI:1366752370
Name:LAPERLE, CAROL HELAINE (MFT)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:HELAINE
Last Name:LAPERLE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:CAROL
Other - Middle Name:HELAINE
Other - Last Name:LAPERLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:423 F STREET
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:530-341-3228
Mailing Address - Fax:530-231-2819
Practice Address - Street 1:423 F STREET
Practice Address - Street 2:SUITE 106
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-341-3228
Practice Address - Fax:530-231-2819
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-12
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 37551106H00000X
CAMFC37551106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist