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General NPI Number Information
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NPI Number | 1770176794
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Entity Type | Organization
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Legal Business Name | BENJAMIN G. HARRIS, M.A., LCPC, LTD.
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Dates
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Enumeration Date | 02/20/2021
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Last Update Date | 02/20/2021
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Provider Practice Location Address
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Address Line | 3333 WARRENVILLE RD STE 200
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City | LISLE
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State | IL
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Zip | 60532-1999
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Country | US
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Telephone | 630-296-4041
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Fax |
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Provider Business Mailing Address
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Address Line | 1302 PEYTON PL
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City | SAINT CHARLES
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State | IL
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Zip | 60174-5058
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Country | US
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Telephone | 815-761-4257
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENJAMIN G HARRIS
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Credential | MA, LCPC
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Telephone | 815-761-4257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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