Provider Demographics
NPI:1972005080
Name:HARSCH, DOUGLAS R (LPC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:R
Last Name:HARSCH
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 1:625 N NORTH CT STE 350
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8160
Mailing Address - Country:US
Mailing Address - Phone:224-801-1700
Mailing Address - Fax:
Practice Address - Street 1:625 N NORTH CT STE 350
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8160
Practice Address - Country:US
Practice Address - Phone:224-801-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.013725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional