Provider Demographics
NPI:1437324266
Name:HARWOOD, JEANNA MARIE (LPC)
Entity Type:Individual
Prefix:
First Name:JEANNA
Middle Name:MARIE
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5172 VILLAGE CREEK DR STE 103
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4444
Mailing Address - Country:US
Mailing Address - Phone:214-504-4420
Mailing Address - Fax:
Practice Address - Street 1:5172 VILLAGE CREEK DR STE 103
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4444
Practice Address - Country:US
Practice Address - Phone:214-504-4420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6878529-3904106H00000X
TX65936101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist