Provider Demographics
NPI:1467188383
Name:WOBECK, HARRISON (MFTC)
Entity Type:Individual
Prefix:
First Name:HARRISON
Middle Name:
Last Name:WOBECK
Suffix:
Gender:M
Credentials:MFTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2532
Mailing Address - Country:US
Mailing Address - Phone:404-985-1368
Mailing Address - Fax:
Practice Address - Street 1:6025 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2532
Practice Address - Country:US
Practice Address - Phone:404-985-1368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MFTC.0014343106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist