Provider Demographics
NPI:1053515528
Name:HARBAUGH, DEENA S (MS, LPC)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:S
Last Name:HARBAUGH
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 N HALL ST
Mailing Address - Street 2:SUITE619
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5105
Mailing Address - Country:US
Mailing Address - Phone:469-324-7909
Mailing Address - Fax:214-275-6900
Practice Address - Street 1:3626 N HALL ST
Practice Address - Street 2:SUITE619
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5105
Practice Address - Country:US
Practice Address - Phone:469-324-7909
Practice Address - Fax:214-275-6900
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17139101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional