Provider Demographics
NPI:1164693800
Name:HARBIN, DAWN MARIE (PHD, LPC)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HARBIN
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5815
Mailing Address - Country:US
Mailing Address - Phone:864-934-7445
Mailing Address - Fax:
Practice Address - Street 1:302 NORTH ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5815
Practice Address - Country:US
Practice Address - Phone:864-934-7445
Practice Address - Fax:864-241-1049
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
SC5424101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC301100Medicaid
SC3333OtherMEDICARE PROVIDER #