Provider Demographics
NPI:1033442330
Name:HARMON, SUSAN KAY (LPC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:KAY
Last Name:HARMON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1491
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-1491
Mailing Address - Country:US
Mailing Address - Phone:719-243-8102
Mailing Address - Fax:719-358-8236
Practice Address - Street 1:1633 MEDICAL CENTER PT
Practice Address - Street 2:STE 253
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8732
Practice Address - Country:US
Practice Address - Phone:719-243-8102
Practice Address - Fax:719-358-8236
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional