Provider Demographics
NPI:1639353352
Name:HARNER, JAMES ROGER (LCAS, CCS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROGER
Last Name:HARNER
Suffix:
Gender:M
Credentials:LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 STATE FARM RD STE 508
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-263-5606
Mailing Address - Fax:828-264-9468
Practice Address - Street 1:610 E CENTER AVE
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115-2578
Practice Address - Country:US
Practice Address - Phone:704-660-1020
Practice Address - Fax:704-660-1024
Is Sole Proprietor?:No
Enumeration Date:2007-12-18
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC501101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6110503Medicaid