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NPI Code Detail

MEDICARE: HANNAH CARLSON LCSW

MEDICARE: HANNAH CARLSON LCSW
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
11041C0700XClinical Social Worker149015184IL

General Provider Information

NPI Number : 1639611601
Entity Type Code : Individual
Provider Name (Legal Business Name) : HANNAH CARLSON LCSW
Provider Business Mailing Address
First Line : 180 N MICHIGAN AVE STE 1040
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7421
Country : US
Telephone Number : 507-304-0912
Fax Number :
Provider Business Practice Location Address
First Line : 180 N MICHIGAN AVE STE 1040
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7421
Country : US
Telephone Number : 507-304-0912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2016
Last Update Date : 05/06/2019

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Directions to “ HANNAH CARLSON LCSW” Practice Location

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