Provider Demographics
NPI:1891171997
Name:HARPER, THOMAS LEE
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:HARPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 PAYNE AVE
Mailing Address - Street 2:190
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-2919
Mailing Address - Country:US
Mailing Address - Phone:216-987-7319
Mailing Address - Fax:216-987-7883
Practice Address - Street 1:1641 PAYNE AVE
Practice Address - Street 2:190
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2919
Practice Address - Country:US
Practice Address - Phone:216-987-7319
Practice Address - Fax:216-987-7883
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS00231841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical