Basic Information
Provider Information | |||||||||
NPI: | 1407212491 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HARPP | ||||||||
FirstName: | BRETT | ||||||||
MiddleName: |   | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | LMHC | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | N/A | ||||||||
OtherFirstName: | N/A | ||||||||
OtherMiddleName: | N/A | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | LMHC-P | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 2214 LENOX RD | ||||||||
Address2: |   | ||||||||
City: | COLLINS | ||||||||
State: | NY | ||||||||
PostalCode: | 140349711 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7163351705 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 2478 GEORGE URBAN BLVD | ||||||||
Address2: |   | ||||||||
City: | DEPEW | ||||||||
State: | NY | ||||||||
PostalCode: | 140432010 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7168967350 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/07/2016 | ||||||||
LastUpdateDate: | 11/21/2020 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 11/21/2020 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 009198-1 | NY | Y |   | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.