Provider Demographics
NPI:1912363672
Name:OHL, CARRIE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ELIZABETH
Last Name:OHL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3436 N HOYNE AVE
Mailing Address - Street 2:APT #1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-6147
Mailing Address - Country:US
Mailing Address - Phone:630-853-4585
Mailing Address - Fax:
Practice Address - Street 1:2600 RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2725
Practice Address - Country:US
Practice Address - Phone:708-317-5926
Practice Address - Fax:708-637-4316
Is Sole Proprietor?:No
Enumeration Date:2016-01-11
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX615161041C0700X
IL149.0172991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical