Provider Demographics
NPI:1093429375
Name:HARRIS, HILLARY (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:
Last Name:HARRIS
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 1:7310 CENTRALIA RD UNIT 432
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:TN
Mailing Address - Zip Code:38029-0170
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4387 BRADCREST CV
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-1801
Practice Address - Country:US
Practice Address - Phone:901-846-0603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4996101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health