Provider Demographics
NPI:1952593287
Name:HARDEN, TIA MARIE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:TIA
Middle Name:MARIE
Last Name:HARDEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 HIGHWAY 72 W STE D
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9531
Mailing Address - Country:US
Mailing Address - Phone:256-325-0424
Mailing Address - Fax:256-325-0429
Practice Address - Street 1:8089 HIGHWAY 72 W STE D
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9531
Practice Address - Country:US
Practice Address - Phone:256-325-0424
Practice Address - Fax:256-325-0429
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500896101YM0800X
AL2896101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health