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General NPI Number Information
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NPI Number | 1013301480
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Entity Type | Individual
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Provider Name | CARLA POINDEXTER
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 1230 N HIGHLAND AVE
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City | AURORA
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State | IL
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Zip | 60506-1401
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Country | US
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Telephone | 630-859-1291
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Fax |
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Provider Business Mailing Address
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Address Line | 13625 MARIGOLD RD
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City | PLAINFIELD
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State | IL
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Zip | 60544-1929
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Country | US
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Telephone | 815-302-0972
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149020037
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License Number State | IL
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