Provider Demographics
NPI:1982830550
Name:MORTON, CARLA HEARL (PHD, MT-BC)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:HEARL
Last Name:MORTON
Suffix:
Gender:F
Credentials:PHD, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 W WARNER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-2873
Mailing Address - Country:US
Mailing Address - Phone:773-497-2959
Mailing Address - Fax:773-866-2958
Practice Address - Street 1:2033 MILWAUKEE AVE STE 334
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3581
Practice Address - Country:US
Practice Address - Phone:847-604-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X, 225A00000X
IL071007641103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist