Provider Demographics
NPI:1467113258
Name:HAASE, TREVOR (LPC)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:HAASE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 KENMORE ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-4338
Mailing Address - Country:US
Mailing Address - Phone:540-251-7728
Mailing Address - Fax:
Practice Address - Street 1:58 KENMORE ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-4338
Practice Address - Country:US
Practice Address - Phone:540-251-7728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-04
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health