Provider Demographics
NPI:1750778916
Name:HARMON, KRISTIN WILLIS (LCSW)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:WILLIS
Last Name:HARMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 STATE FARM ROAD
Mailing Address - Street 2:GREENWAY BLDG 2ND FLOOR
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-263-0121
Mailing Address - Fax:828-268-9050
Practice Address - Street 1:950 STATE FARM ROAD
Practice Address - Street 2:GREENWAY BLDG 2ND FLOOR
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-263-0121
Practice Address - Fax:828-268-9050
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0081251041C0700X
NCC0096351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical