Provider Demographics
NPI:1568687937
Name:HARMAN, TERRY (LCSW)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:HARMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7852 TAFT STREET
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5240
Mailing Address - Country:US
Mailing Address - Phone:219-791-9083
Mailing Address - Fax:
Practice Address - Street 1:10800 W 33RD AVE
Practice Address - Street 2:
Practice Address - City:CEDAR LAKE
Practice Address - State:IN
Practice Address - Zip Code:46303
Practice Address - Country:US
Practice Address - Phone:219-374-4990
Practice Address - Fax:219-374-5175
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33001634A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN351942903OtherTAX ID