Individual
MR. CARLISLE E BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMFT
Contact information
Practice address
901 W SOUTH ST, SALINA, KS 67401-4053
(785) 827-1835
(785) 493-8008
Mailing address
901 W SOUTH ST, SALINA, KS 67401-4053
(785) 827-1835
(785) 493-8008
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
169
KS
106H00000X
Marriage & Family Therapist
31113
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
169
LCMFT
KS
01
—
31113
LMFT
CA
Enumeration date
11/17/2006
Last updated
12/01/2007
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