Provider Demographics
NPI:1275658205
Name:HARBIN, JANICE J (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:J
Last Name:HARBIN
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 COMMERCE CT
Mailing Address - Street 2:
Mailing Address - City:GLADWIN
Mailing Address - State:MI
Mailing Address - Zip Code:48624-1221
Mailing Address - Country:US
Mailing Address - Phone:989-631-0241
Mailing Address - Fax:989-835-9963
Practice Address - Street 1:220 W MAIN ST
Practice Address - Street 2:STE 202
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5184
Practice Address - Country:US
Practice Address - Phone:989-631-0241
Practice Address - Fax:989-835-9963
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802018766101YA0400X, 104100000X
MI6401001984101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No104100000XBehavioral Health & Social Service ProvidersSocial Worker