Individual
MS. ALICIA D CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., LPC, NCC, CSAC
Contact information
Practice address
10610 MAIN ST STE 224, HAYWARD, WI 54843-6586
(715) 634-4806
(715) 634-5387
Mailing address
10561 N RIVERSIDE RD, HAYWARD, WI 54843-4015
(715) 699-0205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
15898-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15916-131
WI
101YM0800X
Mental Health Counselor
5275-125
WI
101YP2500X
Professional Counselor
Primary
5275-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100036439
—
WI
Enumeration date
10/14/2010
Last updated
02/12/2015
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