Provider Demographics
NPI:1982943346
Name:HARPER, WANDA L (MS ED, LCAC CADACII)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:L
Last Name:HARPER
Suffix:
Gender:F
Credentials:MS ED, LCAC CADACII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 Q ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-4718
Mailing Address - Country:US
Mailing Address - Phone:812-279-4673
Mailing Address - Fax:812-279-4672
Practice Address - Street 1:2325 Q ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4718
Practice Address - Country:US
Practice Address - Phone:812-279-4673
Practice Address - Fax:812-279-4672
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN87001517A101YA0400X
101Y00000X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor