Provider Demographics
NPI:1164796991
Name:HARRIS, DIANNAH CAROL (MA, LPC,)
Entity Type:Individual
Prefix:MS
First Name:DIANNAH
Middle Name:CAROL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-0884
Mailing Address - Country:US
Mailing Address - Phone:252-802-1946
Mailing Address - Fax:
Practice Address - Street 1:3640 BARNHILL ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:NC
Practice Address - Zip Code:27812
Practice Address - Country:US
Practice Address - Phone:252-802-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-24
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor