person
Mr. Corie Hargrove, CADC-III
Addiction (Substance Use Disorder) Counselor in Racine, Wisconsin
NPI 1720124019

Corie Hargrove is an Addiction (Substance Use Disorder) Counselor based in Racine, WI and is specialized in Addiction (Substance Use Disorder). Corie Hargrove practices in Racine, WI and has the professional credentials of CADC-III. The NPI Number for Corie Hargrove is 1720124019 and holds a License No. 13772 (Wisconsin).

The current practice location address for Corie Hargrove is 2405 Northwestern Ave # Ll15, Racine, WI and can be reached out via phone at 262-260-8370 and via fax at 262-260-8538.

Location: 2405 Northwestern Ave # Ll15, Racine, WI, 53403-3808
person
Provider Profile Details
NPI Number
1720124019
Provider Name
Corie Hargrove
Credential
CADC-III
Provider Entity Type
Individual
Gender
Male
Address
2405 Northwestern Ave # Ll15, Racine, WI, 53403-3808
Phone Number
262-260-8370
Fax Number
262-260-8538
Provider Enumeration Date
01/30/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
39173200 05 WI
institution
Provider Business Practice Location Address Details
Address
2405 Northwestern Ave # Ll15
City
State
Zip
53404-2534
Phone Number
262-260-8370
Fax Number
262-260-8538
person
Provider Business Mailing Address Details
Address
2405 Northwestern Ave # Ll15
City
State
Zip
53404-2534
Phone Number
262-260-8370
Fax Number
262-260-8538
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
13772 (Wisconsin)
Definition
Definition to come...
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