Provider Demographics
NPI:1013556026
Name:HARRIS, JAMICE SADE' (LLMSW)
Entity Type:Individual
Prefix:
First Name:JAMICE
Middle Name:SADE'
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18747 WOODCREST ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-2013
Mailing Address - Country:US
Mailing Address - Phone:313-459-3480
Mailing Address - Fax:
Practice Address - Street 1:18747 WOODCREST ST
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-2013
Practice Address - Country:US
Practice Address - Phone:313-808-3102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI104100000X
MI6851101144104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker