Provider Demographics
NPI:1801542246
Name:KHARRAZI, JOHN MICHAEL HAMED (LPC)
Entity type:Individual
Prefix:
First Name:JOHN MICHAEL
Middle Name:HAMED
Last Name:KHARRAZI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N ANGLIN ST
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76031-1835
Mailing Address - Country:US
Mailing Address - Phone:817-558-1121
Mailing Address - Fax:
Practice Address - Street 1:1601 N ANGLIN ST
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76031-1835
Practice Address - Country:US
Practice Address - Phone:817-558-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83553101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional