Provider Demographics
NPI:1861895377
Name:HARMON, LOIS (LCPC)
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:HARMON
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 1:1006 STATE HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:JERSEYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62052-2826
Mailing Address - Country:US
Mailing Address - Phone:618-310-3270
Mailing Address - Fax:618-310-3275
Practice Address - Street 1:1006 STATE HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:JERSEYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62052-2826
Practice Address - Country:US
Practice Address - Phone:618-310-3270
Practice Address - Fax:618-310-3275
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health