Provider Demographics
NPI:1093497299
Name:HARRIS, CHARLES HUNTER (MA, LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:HUNTER
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 E RIDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2341
Mailing Address - Country:US
Mailing Address - Phone:210-882-7768
Mailing Address - Fax:
Practice Address - Street 1:123 E RIDGEWOOD CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-2341
Practice Address - Country:US
Practice Address - Phone:210-882-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health