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General NPI Number Information
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NPI Number | 1841714144
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Entity Type | Organization
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Legal Business Name | HARBORBEND COUNSELING
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Dates
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Enumeration Date | 07/28/2017
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 609 E WASHINGTON ST
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City | IDABEL
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State | OK
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Zip | 74745-3319
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Country | US
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Telephone | 580-217-7962
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Fax | 580-297-9163
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Provider Business Mailing Address
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Address Line | 187 BUTLER POOL RD
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City | IDABEL
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State | OK
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Zip | 74745-5793
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Country | US
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Telephone | 580-217-7962
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Fax | 580-297-9163
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Authorized Official
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Title or Position | CEO
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Name | SANDI MOORE
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Credential | LCSW
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Telephone | 580-217-7962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4145
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License Number State | OK
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