Provider Demographics
NPI:1093256877
Name:HARLOW, TINA (LCSW)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:HARLOW
Suffix:
Gender:F
Credentials:LCSW
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 774571
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80477-4571
Mailing Address - Country:US
Mailing Address - Phone:970-819-3577
Mailing Address - Fax:
Practice Address - Street 1:58050 JUPITER PLACE
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:CO
Practice Address - Zip Code:80428
Practice Address - Country:US
Practice Address - Phone:970-819-3577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO13441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical