Provider Demographics
NPI:1598191603
Name:HARN, TERESA (LPC, CSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:HARN
Suffix:
Gender:F
Credentials:LPC, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 JACOBSEN RD
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-1323
Mailing Address - Country:US
Mailing Address - Phone:920-470-0905
Mailing Address - Fax:920-982-5040
Practice Address - Street 1:446 N WESTHILL BLVD
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54914-6532
Practice Address - Country:US
Practice Address - Phone:920-531-2652
Practice Address - Fax:920-982-5040
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional