Provider Demographics
NPI:1548955214
Name:HARPER, FREDERICK CALVIN (LCDC)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:CALVIN
Last Name:HARPER
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12903 BRANT ROCK DR APT 116
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5448
Mailing Address - Country:US
Mailing Address - Phone:832-617-2377
Mailing Address - Fax:
Practice Address - Street 1:12903 BRANT ROCK DR APT 116
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5448
Practice Address - Country:US
Practice Address - Phone:832-617-2377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15748101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty