Provider Demographics
NPI:1285838631
Name:HARNACH, CAROLYN H (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:H
Last Name:HARNACH
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 1:938 W NELSON ST
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6704
Mailing Address - Country:US
Mailing Address - Phone:773-296-3220
Mailing Address - Fax:
Practice Address - Street 1:938 W NELSON ST
Practice Address - Street 2:THIRD FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6704
Practice Address - Country:US
Practice Address - Phone:773-296-3220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical