Provider Demographics
NPI:1295812709
Name:RAWLINS, LARRY DEAN (LCPC)
Entity type:Individual
Prefix:
First Name:LARRY
Middle Name:DEAN
Last Name:RAWLINS
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:IL
Mailing Address - Zip Code:61455-9746
Mailing Address - Country:US
Mailing Address - Phone:309-837-4139
Mailing Address - Fax:309-837-4139
Practice Address - Street 1:28 SHOREWOOD DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:IL
Practice Address - Zip Code:61455-9746
Practice Address - Country:US
Practice Address - Phone:309-837-4139
Practice Address - Fax:309-837-4139
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional