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Individual
PHILLIP CARSON
Active
Individual
PHILLIP CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60638054
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YA400X
COUNSELOR ADDICTION
OR
Enumeration date
10/14/2016
Last updated
08/12/2020
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