Healthcare Provider Details

I. General information

NPI: 1568678167
Provider Name (Legal Business Name): CARLA LYNN HULSLANDER MA, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W EASTMAN ST STE. 305
ARLINGTON HEIGHTS IL
60004-5937
US

IV. Provider business mailing address

565 CARY WOODS CIR
CARY IL
60013-2069
US

V. Phone/Fax

Practice location:
  • Phone: 847-682-4782
  • Fax:
Mailing address:
  • Phone: 847-682-4782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178-003519
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: