Provider Demographics
NPI:1306866132
Name:HARTHUN, PATRICIA JOAN (LCPC, CADC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:JOAN
Last Name:HARTHUN
Suffix:
Gender:F
Credentials:LCPC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9546 S HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1120
Mailing Address - Country:US
Mailing Address - Phone:312-835-7976
Mailing Address - Fax:773-239-9857
Practice Address - Street 1:10725 S WESTERN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3135
Practice Address - Country:US
Practice Address - Phone:312-835-7976
Practice Address - Fax:773-239-9857
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor