Provider Demographics
NPI:1033594098
Name:HARKINS, NANCY (LPC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:HARKINS
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 1:9254 E JENAN DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5868
Mailing Address - Country:US
Mailing Address - Phone:602-996-7932
Mailing Address - Fax:
Practice Address - Street 1:11020 N TATUM BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-6072
Practice Address - Country:US
Practice Address - Phone:602-996-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13416101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLPC13416OtherLICENSE NUMBER
LPC1OtherLICENSE NUMBER