=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275659930
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DENNIS LEE HARMAN M.A., L.M.F.T., LPCC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 03/17/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 112 MAIN ST.
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96093
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-410-1893
-----------------------------------------------------
Fax | 530-623-3007
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1545 131 EAST WEAVER CK RD
-----------------------------------------------------
City | WEAVERVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 96093-1545
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-410-1893
-----------------------------------------------------
Fax | 530-623-3007
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFC 50923
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPCC 1307
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------