Provider Demographics
NPI:1003353954
Name:HARRIS, JOEL (PHD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 THREE BRIDGES CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3552
Mailing Address - Country:US
Mailing Address - Phone:910-398-0188
Mailing Address - Fax:814-377-0185
Practice Address - Street 1:6901 THREE BRIDGES CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3552
Practice Address - Country:US
Practice Address - Phone:910-398-0188
Practice Address - Fax:814-377-0185
Is Sole Proprietor?:No
Enumeration Date:2017-01-30
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5770103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling