Provider Demographics
NPI:1154831576
Name:HARRIS MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:HARRIS MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / RENDERING PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-398-0188
Mailing Address - Street 1:925 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2804
Mailing Address - Country:US
Mailing Address - Phone:814-402-8643
Mailing Address - Fax:
Practice Address - Street 1:925 W COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-2804
Practice Address - Country:US
Practice Address - Phone:910-398-0188
Practice Address - Fax:814-377-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty