Provider Information for 1720453475
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
CARLA FORT LPCC
Other Names:Former Name:CARLA MONIQUE MCLEODSex: Female
NPI: 1720453475
Last Updated: 2023-10-17
Certification Date: 2023-10-17
Certification Date: 2023-10-17
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1720453475 | ||||||||||||||||
| Enumeration Date | 2015-12-07 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1311 LAS BRISAS DR SANTEE, CA 92071-4326 United States Phone: 404-457-4442 | Fax: | ||||||||||||||||
| Primary Practice Address | 1311 LAS BRISAS DR SANTEE, CA 92071-4326 United States Phone: 404-457-4442 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|