Provider Demographics
NPI:1104343847
Name:HARLAND, RICHARD L JR (BS, CACII)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:HARLAND
Suffix:JR
Gender:M
Credentials:BS, CACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 S CAMINO DEL RIO STE 102
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-6856
Mailing Address - Country:US
Mailing Address - Phone:970-828-3030
Mailing Address - Fax:
Practice Address - Street 1:450 S CAMINO DEL RIO STE 102
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-6856
Practice Address - Country:US
Practice Address - Phone:970-828-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB-7495101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)