Provider Demographics
NPI:1396799714
Name:AHONEN, CARL (LMFT)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:AHONEN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1084 JACKMAR RD
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-3501
Mailing Address - Country:US
Mailing Address - Phone:727-736-3717
Mailing Address - Fax:727-736-6611
Practice Address - Street 1:1084 JACKMAR RD
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-3501
Practice Address - Country:US
Practice Address - Phone:727-736-3717
Practice Address - Fax:727-736-6611
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1912106H00000X
NC1073106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist