Provider Demographics
NPI:1588983480
Name:HARPER, MAUREEN TRAVERS (LMHC)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:TRAVERS
Last Name:HARPER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 MARSH LANDING BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-1287
Mailing Address - Country:US
Mailing Address - Phone:904-280-3324
Mailing Address - Fax:904-280-3372
Practice Address - Street 1:4400 MARSH LANDING BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-1287
Practice Address - Country:US
Practice Address - Phone:904-280-3324
Practice Address - Fax:904-280-3372
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health