Provider Demographics
NPI:1215473335
Name:HARTHUN, MICHELLE ALEXIS (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ALEXIS
Last Name:HARTHUN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5607 STONYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-6674
Mailing Address - Country:US
Mailing Address - Phone:815-593-4738
Mailing Address - Fax:
Practice Address - Street 1:5607 STONYBROOK DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-6674
Practice Address - Country:US
Practice Address - Phone:815-593-4738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker