MEDICARE: MRS. HEATHER HARAGA MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	6401014346	MI

General Provider Information

NPI Number	:	1609281633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER HARAGA MA, LPC

Provider Business Mailing Address
First Line	:	635 COVE DR
Second Line	:
City	:	PORT AUSTIN
State	:	MI
Zip	:	48467-9636
Country	:	US
Telephone Number	:	586-246-5887
Fax Number	:

Provider Business Practice Location Address
First Line	:	42815 GARFIELD RD
Second Line	:
City	:	CLINTON TWP
State	:	MI
Zip	:	48038-1143
Country	:	US
Telephone Number	:	586-333-5328
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2014
Last Update Date	:	04/06/2023

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