Individual
MR. STANLEY E CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MDIV,LMHP,CPC,LADC,
Contact information
Practice address
230 E 22ND ST, SUITE #3, FREMONT, NE 68025-2661
(402) 721-8805
(412) 727-4839
Mailing address
230 E 22ND ST, SUITE #3, FREMONT, NE 68025-2661
(402) 721-8805
(412) 727-4839
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
683
NE
101YM0800X
Mental Health Counselor
Primary
18
NE
101YM0800X
Mental Health Counselor
2105
NE
101YP2500X
Professional Counselor
1200
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025637500
—
NE
05
—
10025820000
—
NE
Enumeration date
08/09/2006
Last updated
06/09/2021
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