Provider Demographics
NPI:1134919541
Name:TRAUGOTT, HARLEY
Entity type:Individual
Prefix:
First Name:HARLEY
Middle Name:
Last Name:TRAUGOTT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:HARLEY
Other - Middle Name:
Other - Last Name:PARISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4108 S LIPSCOMB ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79110-1221
Mailing Address - Country:US
Mailing Address - Phone:806-471-8326
Mailing Address - Fax:
Practice Address - Street 1:1001 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1735
Practice Address - Country:US
Practice Address - Phone:888-236-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)