Provider Demographics
NPI:1770453144
Name:CARSON, CATHRYN (MS, RMHCI)
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:CARSON
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:328 N MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3766
Mailing Address - Country:US
Mailing Address - Phone:850-819-3356
Mailing Address - Fax:
Practice Address - Street 1:700 W 23RD ST STE F
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-3936
Practice Address - Country:US
Practice Address - Phone:448-217-4613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH28389101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty