Individual
MRS. CARLA MOHR
Active
Individual
MRS. CARLA MOHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007906
IA
1041C0700X
Clinical Social Worker
14900125
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0581751
—
IL
01
—
149001125
BLUE CROSS ILLINOIS NUMBE
IL
05
—
1581751
—
IL
01
—
99085
BLUE CROSS IOWA NUMBER
IL
01
—
IL01A7
JOHN DEERE PROVIDER NUMBE
IL
01
—
P00122677
RR MEDICARE
IL
Enumeration date
08/26/2005
Last updated
09/04/2012
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