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Individual

ROBERTA J CARLSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LMFT, LSW

Contact information

Practice address
100 POLK COUNTY PLZ, SUITE 50, BALSAM LAKE, WI 54810-9071
(715) 485-8465
(715) 485-8490
Mailing address
25806 W BASS LAKE RD, WEBSTER, WI 54893-8637
(715) 866-4802

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
828-124
WI
1041C0700X
Clinical Social Worker
9945-120
WI

Other

Enumeration date
04/30/2009
Last updated
01/26/2017
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