| Doctor Name: | CAROL LOUINE MANSFIELD |
| NPI Number: | 1205962669 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RI |
| License Number: | RI-M0701032214 |
| Business Practice Address: | 14709 Lakeshore Drive Clearlake, CA - 95422 |
| Business Phone Number: | 7079953235 |
| Business Fax Number: | |
| Mailing Address: | 1830 Lincoln Ave, Po Box 1164 CALISTOGA |
| State: | CA |
| Postal Code: | 945151115 |
| Phone Number: | 7079421179 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | RI-M0701032214 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |