| Doctor Name: | ERIC V HARWELL |
| NPI Number: | 1386994804 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC, QMHP |
| License Number: | 180.004975 |
| Business Practice Address: | 4137 Sauk Trl Suite D Richton Park, IL - 604711253 |
| Business Phone Number: | 7082960214 |
| Business Fax Number: | |
| Mailing Address: | Po Box 1814, MATTESON |
| State: | IL |
| Postal Code: | 604434814 |
| Phone Number: | 7082960214 |
| Fax Number: | |
| NPI Enumeration Date: | 09/12/2012 |
| NPI Last Update Date: | 01/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 180.004975 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |