Provider Demographics
NPI:1033523113
Name:HARRISON, ELIZABETH MANLY (LCSWA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MANLY
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W MILLBROOK RD
Mailing Address - Street 2:STE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4398
Mailing Address - Country:US
Mailing Address - Phone:919-845-9977
Mailing Address - Fax:919-845-9761
Practice Address - Street 1:1011 SCHAUB DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-1862
Practice Address - Country:US
Practice Address - Phone:919-534-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0083411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical