Provider Demographics
NPI:1871501965
Name:HARMON, ROGER (DMIN, LPC, LMFT)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:
Last Name:HARMON
Suffix:
Gender:M
Credentials:DMIN, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17555 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3031
Mailing Address - Country:US
Mailing Address - Phone:281-480-7554
Mailing Address - Fax:281-480-4641
Practice Address - Street 1:17555 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3031
Practice Address - Country:US
Practice Address - Phone:281-480-7554
Practice Address - Fax:281-480-4641
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9413101YP2500X
TX455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84630LOtherBCBS OF TX