Provider Demographics
NPI:1003215575
Name:HARRIS, STELLA KAMILLE JANELL (MS, LCPC)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:KAMILLE JANELL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12912 CONAMAR DR UNIT 1933
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-7505
Mailing Address - Country:US
Mailing Address - Phone:209-596-2045
Mailing Address - Fax:
Practice Address - Street 1:336 S MAIN ST STE 1D
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-3978
Practice Address - Country:US
Practice Address - Phone:209-596-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC9999101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional