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Individual

THOMAS CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1716 FORDEM AVE, MADISON, WI 53704-4604
(608) 221-3511
(608) 221-3514
Mailing address
5408 WILD CHERRY LN, MCFARLAND, WI 53558-8922
(773) 318-5916

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528478286
WI
Enumeration date
05/04/2014
Last updated
08/14/2022
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