Provider Demographics
NPI:1275127730
Name:HARLIN, IVETTE (MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:IVETTE
Middle Name:
Last Name:HARLIN
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11403 CELANDINE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-9265
Mailing Address - Country:US
Mailing Address - Phone:980-214-4885
Mailing Address - Fax:
Practice Address - Street 1:416 MCCULLOUGH DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-4385
Practice Address - Country:US
Practice Address - Phone:980-214-4885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0141201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical