Individual
JESSICA CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, ATR-BC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178.015285
IL
101YP2500X
Professional Counselor
Primary
180.016034
IL
Other
Enumeration date
01/11/2021
Last updated
04/10/2025
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