Sandra Elizabeth Carlson, ED.D. LCPC , RN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180 001650 Issued in IL

Practice address

682 W Boughton Rd
Unit D
Bolingbrook, IL 60440-5700

Phone

(630) 771-0144

Fax

(630) 771-9520

NPI assigned

Nov 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Sandra Carlson & Associates

  • Mental Health Counselor
  • Bolingbrook, IL
  • NPI 1184802167
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1376612168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "682 W BOUGHTON RD",
            "address_2": "UNIT D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405700",
            "telephone_number": "630-771-0144",
            "fax_number": "630-771-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "682 W BOUGHTON RD",
            "address_2": "UNIT D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604405700",
            "telephone_number": "630-771-0144",
            "fax_number": "630-771-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "credential": "ED.D. LCPC , RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180 001650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09932036",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antonio Paolo Carlino, D.O.
• Barbara Carlson
• Barbara Schuman Carlson, LCPC
• Breanna Kaitlyn Carlson
• Jordan David Carlson, LPC
• Jaime Elizabeth Carney Leith
• Rebecca Carney
• Anna J Carter, MSW, LCSW
• Ines M Casey, M.D.
• Patricia Victoria D. Castro- Ladra, P.T.

• Mental Health Counselor in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; 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.