Michaela Blaire Harrison, LCPC
Counselor, Professional in Fairfield, IL. Individual provider (NPI-1).
NPI number1962012260
StatusActive
Last updated in NPPESOct 10, 2025
Details
- NPI
- 1962012260
- Entity type
- Individual (NPI-1)
- Name
- Michaela Blaire Harrison
- Credential
- LCPC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 3, 2020
- Certification date
- Oct 10, 2025
- Last updated
- Oct 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180013059 | IL | Yes |
| 101YM0800X | Counselor, Mental Health | 180013059 | IL |
Practice location
9 Fawn DrFairfield, IL 62837-2800
Phone 618-718-1114 · Fax 877-681-0190
Mailing address
9 Fawn DrFairfield, IL 62837-2800
Phone 618-718-1114 · Fax 877-681-0190
Other practice locations
2020 Broadway St Ste A
Mount Vernon, IL 62864-2973
Mount Vernon, IL 62864-2973
Phone 618-718-1114 · Fax 877-681-0190
215 Se 3rd St
Fairfield, IL 62837-2160
Fairfield, IL 62837-2160
Phone 618-718-1114 · Fax 877-681-0190
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