Basic Information
| Provider Information | |||||||||
| NPI: | 1528027521 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAARMANN | ||||||||
| FirstName: | KIMI | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | PROF. | ||||||||
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| Credential: | MSED.LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 ASHWOOD DR | ||||||||
| Address2: | 1200 NORTH FOURTH ST. (PO BOX 1047) | ||||||||
| City: | EFFINGHAM | ||||||||
| State: | IL | ||||||||
| PostalCode: | 624015101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173429705 | ||||||||
| FaxNumber: | 2173426716 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 N 4TH ST | ||||||||
| Address2: | |||||||||
| City: | EFFINGHAM | ||||||||
| State: | IL | ||||||||
| PostalCode: | 624013032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2173477179 | ||||||||
| FaxNumber: | 2173426716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | IL | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.