Individual
LAWRENCE EDWARD HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, BSW, CADC
Contact information
Practice address
5230 6TH STREET FRONTAGE RD E, SPRINGFIELD, IL 62703-5128
(217) 585-1180
Mailing address
459 W COOK ST, SPRINGFIELD, IL 62704-2533
(217) 220-0082
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
27172
IL
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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