Healthcare Provider Details

I. General information

NPI: 1205376209
Provider Name (Legal Business Name): LAURA HARMON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA JEAN HARMON

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2712 E JOHNSON AVE
JONESBORO AR
72405-1874
US

IV. Provider business mailing address

1815 PLEASANT GROVE ROAD
JONESBORO AR
72405-7870
US

V. Phone/Fax

Practice location:
  • Phone: 870-932-2800
  • Fax:
Mailing address:
  • Phone: 870-933-6886
  • Fax: 870-933-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10033-C
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: