Provider Demographics
NPI:1073206744
Name:HARRIS, EBONY K (LMHC)
Entity Type:Individual
Prefix:MS
First Name:EBONY
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3109
Mailing Address - Country:US
Mailing Address - Phone:917-426-5549
Mailing Address - Fax:
Practice Address - Street 1:99 MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3109
Practice Address - Country:US
Practice Address - Phone:845-675-8433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012958-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health