Provider Demographics
NPI:1427423177
Name:HARMON, MICHELLE L (LPCC)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:L
Last Name:HARMON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 EAGLE ROCK AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-3853
Mailing Address - Country:US
Mailing Address - Phone:505-259-6868
Mailing Address - Fax:
Practice Address - Street 1:9400 EAGLE ROCK AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-3853
Practice Address - Country:US
Practice Address - Phone:505-259-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-07
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0172911101YM0800X
NMCCMH0196561101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM57723010Medicaid