Individual
LILLIAN A CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 221-3511
(608) 221-3514
Mailing address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 221-3511
(608) 221-3514
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4072-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124661996
—
WI
Enumeration date
10/23/2019
Last updated
08/17/2023
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