Provider Demographics
NPI:1083761795
Name:CAROL MCCARDELL, LCSW, LTD
Entity Type:Organization
Organization Name:CAROL MCCARDELL, LCSW, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:847-835-2040
Mailing Address - Street 1:1022 CHERRY TREE LN
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-1006
Mailing Address - Country:US
Mailing Address - Phone:847-835-2040
Mailing Address - Fax:847-835-7067
Practice Address - Street 1:1604 CHICAGO AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-6017
Practice Address - Country:US
Practice Address - Phone:847-328-9939
Practice Address - Fax:847-835-7067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health