Carlyn R Williams, MA, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013978 Issued in IL

Practice address

1860 W Winchester Rd Ste 205
Libertyville, IL 60048-5317

Phone

(224) 424-4194

NPI assigned

Dec 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carlyn Vadnais Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• The McKnight Group LLC

  • Professional Counselor
  • Libertyville, IL
  • NPI 1447778972
  NPD

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

{
    "created_epoch": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1770121576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD STE 205",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 W WINCHESTER RD STE 205",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485317",
            "telephone_number": "224-424-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CARLYN",
        "middle_name": "R",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.015415",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "CMS",
            "affiliation": "N",
            "endpointDescription": "ClinicSource",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "unknown",
            "address_1": "1860 W Winchester Rd Ste 205",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CARLYN",
            "last_name": "VADNAIS",
            "credential": "MA, LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cody Adam Wilgus, PHARMD
• Ava Lake Wilhelm
• Beth Anne Wilkowski, MPT
• William a. Martinezmdsc
• Anna Williams
• Erica R Williams, OTR/L
• Hannah Ellen Williams, FNP-C, APRN
• Karlee Williams, LSW
• Matthew Williams, LCSW
• Willow Oak Pediatrics

• Professional Counselor in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.