Provider Demographics
NPI:1417305418
Name:PORTER-HARMON, REBECCA (MA, BCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:PORTER-HARMON
Suffix:
Gender:F
Credentials:MA, BCC
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 QQ
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-0700
Mailing Address - Country:US
Mailing Address - Phone:571-335-5431
Mailing Address - Fax:
Practice Address - Street 1:1716 OLD CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-0700
Practice Address - Country:US
Practice Address - Phone:571-335-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-31
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health