MS. WENDY MARIE CARLSON PMHNP-BC NPI 1891158564

NPI Information

NPI: 1891158564
Provider Name: MS. WENDY MARIE CARLSON, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
21 SHORE RD
BERKLEY, MA
ZIP 02779
Phone: (774) 501-1440
Get Directions

MS. Wendy Marie Carlson, PMHNP-BC is a psychiatric/mental health nurse practitioner in Berkley, MA with 8 years of experience. MS. Wendy Marie Carlson, PMHNP-BC NPI is 1891158564. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

21 SHORE RD
BERKLEY, MA
ZIP 02779-324
Phone: (774) 501-1440
Fax: (508) 967-7304

The NPI 1891158564 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2016 and was last updated on 8/14/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		230033	MASSACHUSETTS	No
2	163W00000X	Registered Nurse		48702	RHODE ISLAND	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	RN230033	MASSACHUSETTS	Yes
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	APRN01440	RHODE ISLAND	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	APRN01440	OTHER	RHODE ISLAND	APRN
2	RN230033	OTHER	MASSACHUSETTS	APRN
3	MC4398120	OTHER	MASSACHUSETTS	CONTROLLED SUBSTANCE REGISTRATION
4	S400325789	MEDICAID	MASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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