Provider Demographics
NPI:1588194989
Name:HARLESTON, TRAVIS LEVI (LMFT)
Entity Type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:LEVI
Last Name:HARLESTON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MING AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-9120
Mailing Address - Country:US
Mailing Address - Phone:661-477-8969
Mailing Address - Fax:
Practice Address - Street 1:5500 MING AVE STE 210
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-9120
Practice Address - Country:US
Practice Address - Phone:661-834-8341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA134041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist