Provider Demographics
NPI:1245376912
Name:HARMON, DAVE EDWARD
Entity type:Individual
Prefix:MR
First Name:DAVE
Middle Name:EDWARD
Last Name:HARMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:DAVE
Other - Middle Name:
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, CADC, ICADC
Mailing Address - Street 1:4010 DUPONT CIR
Mailing Address - Street 2:SUITE 226
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4812
Mailing Address - Country:US
Mailing Address - Phone:502-896-8006
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR
Practice Address - Street 2:SUITE 226
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4812
Practice Address - Country:US
Practice Address - Phone:502-896-8006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY74 DOM VIOLENCE101Y00000X
KY32 SEX OFFENDER COUN101Y00000X
KY418 PRO GAMBL, ACGCC101Y00000X
KY0037101YA0400X
KY8027 NADAC101YA0400X
KY2901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY418OtherNATIONAL, COMP GAMBLING
KY290OtherLCSW
KY74OtherDOMESTIC VIOLENCE COUNSEL
KY32OtherSEX OFFENDER COUNSELOR
KYOO37OtherCADC, CHEMICAL DEP
KY8207OtherNADAC CHEM DEP, NATION
KY90208OtherNATIONAL- NADAC