Provider Demographics
NPI:1649395153
Name:CROSSER, CARMEN LYNN (MSW LCSW LMFT)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:LYNN
Last Name:CROSSER
Suffix:
Gender:F
Credentials:MSW LCSW LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2742 PATTEN AVE
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3941
Mailing Address - Country:US
Mailing Address - Phone:630-845-2997
Mailing Address - Fax:630-845-1502
Practice Address - Street 1:400 E HILLCREST DRIVE
Practice Address - Street 2:SUITE 100A
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-2480
Practice Address - Country:US
Practice Address - Phone:630-337-8502
Practice Address - Fax:630-845-1502
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist