Provider Demographics
NPI:1821493404
Name:LOVE, HAROLD JEROME (LPC)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:JEROME
Last Name:LOVE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8422 S SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48348-2674
Mailing Address - Country:US
Mailing Address - Phone:248-730-2905
Mailing Address - Fax:
Practice Address - Street 1:16250 NORTHLAND DR STE 204
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075
Practice Address - Country:US
Practice Address - Phone:248-730-2905
Practice Address - Fax:248-599-7522
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-25
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional