Provider Demographics
NPI:1659502193
Name:GROOMS, HARLAN HOBART III (M DIV, M ED LPC)
Entity Type:Individual
Prefix:
First Name:HARLAN
Middle Name:HOBART
Last Name:GROOMS
Suffix:III
Gender:M
Credentials:M DIV, M ED LPC
Other - Prefix:
Other - First Name:BART
Other - Middle Name:
Other - Last Name:GROOMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:M DIV, M ED LPC
Mailing Address - Street 1:2872 ACTON RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2502
Mailing Address - Country:US
Mailing Address - Phone:205-795-7734
Mailing Address - Fax:205-967-3664
Practice Address - Street 1:2872 ACTON RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2502
Practice Address - Country:US
Practice Address - Phone:205-795-7734
Practice Address - Fax:205-967-3664
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1720101YP2500X
ALL138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional