Healthcare Provider Details

I. General information

NPI: 1386855583
Provider Name (Legal Business Name): THERESA MARIE HARMON LICSW, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MAIN STREET EXT STE 615
PLYMOUTH MA
02360-3366
US

IV. Provider business mailing address

129 RUSSELL MILLS RD
PLYMOUTH MA
02360-3018
US

V. Phone/Fax

Practice location:
  • Phone: 941-391-0746
  • Fax:
Mailing address:
  • Phone: 941-391-0746
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN10005249
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116116
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: