Provider Demographics
NPI:1104155787
Name:CARLSTEDT, KASEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:KASEE
Middle Name:
Last Name:CARLSTEDT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KASEE
Other - Middle Name:
Other - Last Name:MATTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2205 N WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1602
Mailing Address - Country:US
Mailing Address - Phone:765-284-0043
Mailing Address - Fax:765-284-4112
Practice Address - Street 1:2205 N WHEELING AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1602
Practice Address - Country:US
Practice Address - Phone:765-284-0043
Practice Address - Fax:765-284-4112
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042394A103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical