Provider Demographics
NPI:1699222836
Name:HARLOW, ALICIA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:J
Last Name:HARLOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 3RD ST FL 1
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-4037
Mailing Address - Country:US
Mailing Address - Phone:518-285-0295
Mailing Address - Fax:
Practice Address - Street 1:5 PINE WEST PLZ
Practice Address - Street 2:SUITE 511
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5593
Practice Address - Country:US
Practice Address - Phone:518-285-0295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-06
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TC1900X
NY021521103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling