Individual provider · Type 1 NPI

Stacy Marie Carlson, MS, CRC, LPC-IT

Professional Counselor · Portage, WI

NPI number 1659890416 Active

Practice location

322 Dewitt St
Portage, WI 53901-2114

Mailing address

25 Kessel Ct Ste 105
Madison, WI 53711-6227

Specialties and licenses

TaxonomyCodeLicense
Professional Counselor Primary 101YP2500X3232 (WI)

Professional Counselor: Definition to come...

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About NPI 1659890416

Stacy Marie Carlson, MS, CRC, LPC-IT's National Provider Identifier is 1659890416, issued on Sep 13, 2017. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Portage, WI. The record was last updated on Sep 13, 2017.