Individual
LYNNETTE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1319 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2000
(812) 331-1235
(812) 353-6137
Mailing address
1319 W BLOOMFIELD RD, BLOOMINGTON, IN 47403-2000
(812) 331-1235
(812) 353-6137
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
39000586A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000545373
ANTHEM NON-PAR PIN NUMBER
IN
Enumeration date
05/02/2010
Last updated
05/02/2010
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