Healthcare Provider Details

I. General information

NPI: 1205769437
Provider Name (Legal Business Name): CARLOS ARZOLA LPC, MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2259 S DAMEN AVE
CHICAGO IL
60608-4232
US

IV. Provider business mailing address

2259 S DAMEN AVE
CHICAGO IL
60608-4232
US

V. Phone/Fax

Practice location:
  • Phone: 872-281-7575
  • Fax: 773-801-0084
Mailing address:
  • Phone: 872-281-7575
  • Fax: 773-801-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.023207
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: