Provider Demographics
NPI:1881704799
Name:HARBECK, JUDITH D
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:D
Last Name:HARBECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1928 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2443
Mailing Address - Country:US
Mailing Address - Phone:425-259-2176
Mailing Address - Fax:425-252-0793
Practice Address - Street 1:2735 10TH ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1413
Practice Address - Country:US
Practice Address - Phone:425-258-4802
Practice Address - Fax:425-252-0793
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00033908101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00033908OtherREGISTERED COUNSELOR