Provider Demographics
NPI:1396138376
Name:RONDELL HARJU, LCSW
Entity type:Organization
Organization Name:RONDELL HARJU, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RONDELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARJU
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:931-924-4080
Mailing Address - Street 1:4065 CHALLIS DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-2533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4065 CHALLIS DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-2533
Practice Address - Country:US
Practice Address - Phone:931-624-4080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-14
Last Update Date:2015-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3489251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health