Individual
BRIANNE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
913 W. WELLINGTON, CHICAGO, IL 60657
(847) 946-8854
Mailing address
26304 N MIDDLETON PKWY, MUNDELEIN, IL 60060-9126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149023779
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149023779
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
12/06/2021
Last updated
12/06/2021
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