Provider Demographics
NPI:1295977452
Name:HARLAN, DEBRA JO (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JO
Last Name:HARLAN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E HARDY ST
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-2249
Mailing Address - Country:US
Mailing Address - Phone:417-207-6908
Mailing Address - Fax:
Practice Address - Street 1:777 E BATTLEFIELD ST
Practice Address - Street 2:SUITE 102, B
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4807
Practice Address - Country:US
Practice Address - Phone:417-597-4572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090061251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical