Organization
SAGE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CLARE CARLSON LCPC (MENTAL HEALTH THERAPIST)
(630) 649-9087
Entity
Organization
Contact information
Practice address
210 N HAMMES AVE, JOLIET, IL 60435-6680
(630) 649-9087
Mailing address
210 N HAMMES AVE, JOLIET, IL 60435-6680
(630) 649-9087
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180.009476
IDPFR
IL
Enumeration date
10/28/2021
Last updated
10/28/2021
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