Provider Demographics
NPI:1760964738
Name:KAUR, HARSIMRAN (LPCIT)
Entity Type:Individual
Prefix:
First Name:HARSIMRAN
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:LPCIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 W LISBON RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-1634
Mailing Address - Country:US
Mailing Address - Phone:262-364-6798
Mailing Address - Fax:
Practice Address - Street 1:1971 WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:WI
Practice Address - Zip Code:53024-2125
Practice Address - Country:US
Practice Address - Phone:262-377-6276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-10-03
Deactivation Date:2018-09-11
Deactivation Code:
Reactivation Date:2018-10-03
Provider Licenses
StateLicense IDTaxonomies
WI27125-226101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor