| Micah Kevin Carlson, LCSW | |
|
5617 Scotts Valley Dr, Scotts Valley, CA 95066-3482 | |
| (831) 768-6736 | |
| Not Available |
| Full Name | Micah Kevin Carlson |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 5617 Scotts Valley Dr, Scotts Valley, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699387092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 101756 (California) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Entity Name | Grow Healthcare Group Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 |
| Mailing Address | Practice Location Address |
|---|---|
| Micah Kevin Carlson, LCSW 3785 Via Nona Marie Ste 108, Carmel, CA 93923-8637 Ph: (951) 743-4283 | Micah Kevin Carlson, LCSW 5617 Scotts Valley Dr, Scotts Valley, CA 95066-3482 Ph: (831) 768-6736 |
Carol Pruitt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4113 Scotts Valley Dr Ste 104, Scotts Valley, CA 95066 Phone: 831-429-2288 Fax: 831-461-9700 | |
Kristin Mc Donald, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 940 Disc Dr, Scotts Valley, CA 95066 Phone: 831-430-3000 | |
Kara Roberta Kasteen, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4113 Scotts Valley Dr Ste 212, Scotts Valley, CA 95066 Phone: 408-673-8646 | |
Erin Burton Josselyn, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 125 Bethany Dr Ste 203, Scotts Valley, CA 95066 Phone: 831-498-4445 | |
Ms. Stacy Blasi, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4404 Scotts Valley Dr, Suite D, Scotts Valley, CA 95066 Phone: 831-401-3220 | |
Amy Denise Marlo, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 940 Disc Dr, Scotts Valley, CA 95066 Phone: 831-430-3000 |