Individual
MR. THOMAS PATRICK CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.
Contact information
Practice address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2222
Mailing address
1320 WISCONSIN AVE, RACINE, WI 53403-1978
(262) 687-2222
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4208-125
WI
101YP2500X
Professional Counselor
Primary
4208
WI
Other
Enumeration date
05/03/2013
Last updated
12/11/2018
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