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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

NPI Number 1801994199
LBN Legal business name C JESSE CARLOCK PH D & ASSOCIATES
Authorized official CHARLENE CARLOCK - (OWNER /PSYCHOLOGIST)
Entity Organization
Organization subpart 1 No
Enumeration date 09/20/2006
Last updated 10/13/2009 - About 17 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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