Provider Demographics
NPI:1982360962
Name:HARMON, KELSEY LEE (LMSW)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:LEE
Last Name:HARMON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 34TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1217
Mailing Address - Country:US
Mailing Address - Phone:512-212-4670
Mailing Address - Fax:
Practice Address - Street 1:630 W 34TH ST STE 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1232
Practice Address - Country:US
Practice Address - Phone:512-212-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-13
Last Update Date:2021-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker