MEDICARE: KAROLINA HOGUEISSON LCPC LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180007576	IL

General Provider Information

NPI Number	:	1548741531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAROLINA HOGUEISSON LCPC LTD

Provider Business Mailing Address
First Line	:	PO BOX 42
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-0042
Country	:	US
Telephone Number	:	847-208-4223
Fax Number	:	708-844-6069

Provider Business Practice Location Address
First Line	:	15020 S RAVINIA AVE STE 23
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-5352
Country	:	US
Telephone Number	:	847-208-4223
Fax Number	:	708-844-6069

Authorized Official
Title or Position	:	OWNER
Name	:	KAROLINA HOGUEISSON
Credential	:	LCPC
Telephone Number	:	847-208-4223

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	08/27/2018

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