Provider Demographics
NPI:1053527242
Name:LOGALBO, CAROLE S (LCPC)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:S
Last Name:LOGALBO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:0N706 CONCORD LN
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1085
Mailing Address - Country:US
Mailing Address - Phone:630-668-4594
Mailing Address - Fax:630-668-4566
Practice Address - Street 1:493 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-4104
Practice Address - Country:US
Practice Address - Phone:630-469-1555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional