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General NPI Number Information
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NPI Number | 1689678302
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Entity Type | Individual
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Provider Name | STANLEY RAY HARLAN M.DIV., M.ED.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 300 S C M ALLEN PKWY STE 400
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City | SAN MARCOS
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State | TX
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Zip | 78666-6954
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Country | US
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Telephone | 512-396-8540
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Fax | 512-396-5680
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Provider Business Mailing Address
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Address Line | 300 S C M ALLEN PKWY STE 400
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City | SAN MARCOS
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State | TX
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Zip | 78666-6954
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Country | US
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Telephone | 512-665-2083
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Fax | 512-396-5680
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 003277
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 10684
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License Number State | TX
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