Carson Brandt, MA LPC
Individual provider Active NPI Counselor · Sycamore, IL
NPI 1841018298 · NPPES record last updated Oct 2, 2024
Key facts
- NPI
- 1841018298
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 178.020601 (IL)
- Practice address
- 240 Edward St
Sycamore, IL 60178-2155 - Phone
- (847) 707-2689
- NPI assigned
- Oct 2, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.020601 | IL | MD | Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.020601 | IL | Yes |
Addresses
Primary practice location
240 Edward St
Sycamore, IL 60178-2155
Mailing address
23 115TH St
Lemont, IL 60439-8754
Phone (630) 449-2607
Other practice location 1
1595 Weld Rd
Elgin, IL 60123-5896
Phone (847) 707-2689
Other providers in Sycamore, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.