Provider Demographics
NPI:1144373283
Name:HARMAN, PAUL L (LCSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:HARMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2843 DENISE AVE
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-7543
Mailing Address - Country:US
Mailing Address - Phone:208-734-1281
Mailing Address - Fax:208-734-1282
Practice Address - Street 1:794 EASTLAND DR
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6856
Practice Address - Country:US
Practice Address - Phone:208-734-1281
Practice Address - Fax:208-734-1282
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052893101YP2500X
IDLCSW299161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID8084177Medicaid
WA8941877OtherCRIME VICTIMS