Provider Demographics
NPI:1033463229
Name:HARRIS, CHAMARA (LBSW-IPR, LPC)
Entity Type:Individual
Prefix:
First Name:CHAMARA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LBSW-IPR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15222 SNOW HILL CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2150
Mailing Address - Country:US
Mailing Address - Phone:832-275-2673
Mailing Address - Fax:
Practice Address - Street 1:15222 SNOW HILL CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2150
Practice Address - Country:US
Practice Address - Phone:832-275-2673
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60459101YP2500X
TX357681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional