Michaela Blaire Harrison, LCPC
Individual provider Active NPI Professional Counselor · Fairfield, IL
NPI 1962012260 · NPPES record last updated Oct 10, 2025
Key facts
- NPI
- 1962012260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 180013059 (IL)
- Practice address
- 9 Fawn Dr
Fairfield, IL 62837-2800 - Phone
- (618) 718-1114
- Fax
- (877) 681-0190
- NPI assigned
- Aug 3, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180013059 | IL | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Enlighten Counseling and Wellness, PLCC | Mental Health | Current |
Accepting new patients |
| Aspire Integrated Health, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180013059 | IL | Yes |
| Mental Health Counselor | 101YM0800X | 180013059 | IL |
Addresses
Primary practice location
9 Fawn Dr
Fairfield, IL 62837-2800
Mailing address
9 Fawn Dr
Fairfield, IL 62837-2800
Phone (618) 718-1114
Other practice location 1
215 SE 3rd St
Fairfield, IL 62837-2160
Phone (618) 718-1114
Other practice location 2
2020 Broadway St Ste A
Mount Vernon, IL 62864-2973
Phone (618) 718-1114
Other providers in Fairfield, IL
- Melissa D. Gibbs
- Dana Lynn Gilbert
- Lauren Griswold
- Francis Guerra-Bauman
- Bryce Michael Harrison
- Clint Harvey
- Kathy Hatton
- Deana Lynne Hawkins
- Ross Herdes
- Highland Park CVS, L.L.C.
All providers in Fairfield, IL · Professional Counselor in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.