Provider Demographics
NPI:1720691074
Name:RITA A. CARLSON, PSY.D., PLLC
Entity type:Organization
Organization Name:RITA A. CARLSON, PSY.D., PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:775-315-2980
Mailing Address - Street 1:191 SHADY GROVE LN
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NV
Mailing Address - Zip Code:89403-6364
Mailing Address - Country:US
Mailing Address - Phone:775-315-2980
Mailing Address - Fax:
Practice Address - Street 1:1201 TERMINAL WAY STE 111
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3398
Practice Address - Country:US
Practice Address - Phone:775-657-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty