Harlan David Wallner, RMHCI

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH18079 Issued in FL

Practice address

1101 Gulf Breeze Parkway
BLDG 5, Ste 12
Gulf Breeze, FL 32561-4892

Phone

(850) 757-3976

NPI assigned

Nov 20, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1396381794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 HENCYE DR APT B",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325147723",
            "telephone_number": "850-748-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GULF BREEZE PARKWAY",
            "address_2": "BLDG 5, STE 12",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614892",
            "telephone_number": "850-757-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLNER",
        "first_name": "HARLAN",
        "middle_name": "DAVID",
        "credential": "RMHCI",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH18079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.