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General NPI Number Information
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NPI Number | 1174909105
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Entity Type | Individual
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Provider Name | ELIZABETH CARLSON LCPC, CADC
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Gender | Female
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Dates
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Enumeration Date | 07/31/2015
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 300 S CARLTON AVE STE 110
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City | WHEATON
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State | IL
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Zip | 60187-4830
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Country | US
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Telephone | 630-668-4411
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Fax |
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Provider Business Mailing Address
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Address Line | 1212 GOLF CIR
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City | WHEATON
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State | IL
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Zip | 60189-6331
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Country | US
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Telephone | 630-871-4584
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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