Provider Demographics
NPI:1396085635
Name:HARLACHER, ERIC (CADCA)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:HARLACHER
Suffix:
Gender:M
Credentials:CADCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 IRVING DR
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-1833
Mailing Address - Country:US
Mailing Address - Phone:818-415-5706
Mailing Address - Fax:
Practice Address - Street 1:65 N MADISON AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2035
Practice Address - Country:US
Practice Address - Phone:818-415-5706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACADCA (I3760312)101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)