Individual provider Active NPI

Adam Carlson

  • Mental Health Counselor
  • Elgin, IL
National Provider Identifier
1124965504
Registry record updated May 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1752 Capital St
Elgin, IL 60124-7896
Phone
(847) 695-3680
Fax
(847) 695-3680
NPI assigned
May 2, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IL Primary

Addresses

Primary practice location

1752 Capital St
Elgin, IL 60124-7896

Mailing address

605 Garden Rd
Dekalb, IL 60115-2303
Phone (503) 726-9362

Other names 1

  • Willow Carlson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family Service Association of Greater Elgin Area PastSince Nov 20, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777680000000",
    "number": "1124965504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 GARDEN RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152303",
            "telephone_number": "503-726-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 CAPITAL ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601247896",
            "telephone_number": "847-695-3680",
            "fax_number": "847-695-3680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-05-02",
        "last_updated": "2026-05-02",
        "certification_date": "2026-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLOW",
            "last_name": "CARLSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.