1407174832 NPI number — MS. JOAN COLETTE CARIE LCSW, LMFT

Table of content: MS. JOAN COLETTE CARIE LCSW, LMFT (NPI 1407174832)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407174832 NPI number — MS. JOAN COLETTE CARIE LCSW, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARIE
Provider First Name:
JOAN
Provider Middle Name:
COLETTE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407174832
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4770 COVERT AVE
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
EVANSVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-475-3420
Provider Business Mailing Address Fax Number:
812-475-3470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4770 COVERT AVE
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
EVANSVILLE
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-475-3420
Provider Business Practice Location Address Fax Number:
812-475-3470
Provider Enumeration Date:
05/10/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  34005188A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106H00000X , with the licence number: 34005188A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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