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Contact Information

C JESSE CARLOCK PH D & ASSOCIATES
1105 WATERVLIET AVE
DAYTON, OH45420
 Phone: 937-256-0500
 Fax: 937-256-2136
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Mental Health

101YM0800X
Indicates primary specialty

NPI Profile & details for C JESSE CARLOCK PH D ASSOCIATES · (Female)

NPI # 1801994199
Status Active
Credentials
Entity Individual
Enumeration date 09/20/2006
Last updated 10/13/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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