Provider Demographics
NPI:1821106675
Name:HARSHMAN, WILLIAM LESLIE (PHD, LMSW, LLP, CAC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LESLIE
Last Name:HARSHMAN
Suffix:
Gender:M
Credentials:PHD, LMSW, LLP, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10785 S SAGINAW ST
Mailing Address - Street 2:BUILDING E
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7003
Mailing Address - Country:US
Mailing Address - Phone:810-695-0055
Mailing Address - Fax:810-695-6813
Practice Address - Street 1:10785 S SAGINAW ST
Practice Address - Street 2:BUILDING E
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7003
Practice Address - Country:US
Practice Address - Phone:810-695-0055
Practice Address - Fax:810-695-6813
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007572101YP2500X
MI6301007032103TC0700X
MI68010660341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical