Provider Demographics
NPI:1164716361
Name:HARMON, RALPH L JR (LMSW, CAADC)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:L
Last Name:HARMON
Suffix:JR
Gender:M
Credentials:LMSW, CAADC
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 10
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-0010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 W WASHINGTON ST STE F
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4367
Practice Address - Country:US
Practice Address - Phone:906-250-2382
Practice Address - Fax:906-627-6337
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801074257104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker