Provider Demographics
NPI:1154176279
Name:HARPER, DOUGLAS MICHAEL (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:MICHAEL
Last Name:HARPER
Suffix:
Gender:M
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 MAYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37416-3108
Mailing Address - Country:US
Mailing Address - Phone:423-503-7438
Mailing Address - Fax:
Practice Address - Street 1:7609 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2633
Practice Address - Country:US
Practice Address - Phone:423-503-7438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6762101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional