Individual provider · Type 1 NPI

Michael John Carlson

Mental Health Counselor · Bloomington, IL

NPI number 1780723254 Active

Practice location

108 W Market St
Bloomington, IL 61701-3918

Call (309) 827-5351 Map

Fax (309) 829-6808

Mailing address

801 N Mclean St, Apt. #6
Bloomington, IL 61701-3170

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1780723254

Michael John Carlson's National Provider Identifier is 1780723254, issued on Feb 5, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bloomington, IL. The record was last updated on Jul 8, 2007.