Provider Demographics
NPI:1043541212
Name:HARRISON, DEBBIE S (LPC, MHSP)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:S
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8829 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38671-2610
Mailing Address - Country:US
Mailing Address - Phone:662-280-5758
Mailing Address - Fax:662-280-5708
Practice Address - Street 1:8829 CENTRE ST
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38671-2610
Practice Address - Country:US
Practice Address - Phone:662-280-5758
Practice Address - Fax:662-280-5708
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001777101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health