MEDICARE: MR. PATRICK HARNISH LMHC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	081467	IA
2	101YM0800X	Mental Health Counselor	081467	IA

General Provider Information

NPI Number	:	1336534015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK HARNISH LMHC, NCC

Provider Business Mailing Address
First Line	:	420 KELLOGG AVE
Second Line	:
City	:	AMES
State	:	IA
Zip	:	50010-6226
Country	:	US
Telephone Number	:	641-425-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	202 1ST ST SE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-3946
Country	:	US
Telephone Number	:	641-425-7100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	08/25/2021

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