Provider Demographics
NPI:1962649087
Name:HARBURG, CLARA ANN (LMHC)
Entity type:Individual
Prefix:MS
First Name:CLARA
Middle Name:ANN
Last Name:HARBURG
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 1:93436 BROOKRIDGE LANE
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:FL
Mailing Address - Zip Code:34219-9300
Mailing Address - Country:US
Mailing Address - Phone:941-776-1578
Mailing Address - Fax:941-776-1578
Practice Address - Street 1:3402 MAGIC OAK LN
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-1812
Practice Address - Country:US
Practice Address - Phone:941-776-1578
Practice Address - Fax:941-776-1578
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH004127101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health