Provider Demographics
NPI:1679753339
Name:HEDIN, HAROLD MICHAEL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:MICHAEL
Last Name:HEDIN
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 LANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9705
Mailing Address - Country:US
Mailing Address - Phone:217-819-7124
Mailing Address - Fax:
Practice Address - Street 1:35 LANGE AVE
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9705
Practice Address - Country:US
Practice Address - Phone:217-819-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-11
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0121111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical