Provider Demographics
NPI:1538610449
Name:HARMON, DAVID (MA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:DAVE
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:919 WALBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-2337
Mailing Address - Country:US
Mailing Address - Phone:814-898-1669
Mailing Address - Fax:
Practice Address - Street 1:919 WALBRIDGE RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-2337
Practice Address - Country:US
Practice Address - Phone:814-898-1669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-17
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional