Provider Demographics
NPI:1194019844
Name:KIRKLAND-HARRIS, LINDA IRENE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:IRENE
Last Name:KIRKLAND-HARRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 CHAMPIONS WAY
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-3764
Mailing Address - Country:US
Mailing Address - Phone:757-227-3076
Mailing Address - Fax:757-227-3212
Practice Address - Street 1:400 N CENTER DR
Practice Address - Street 2:BUILDING 3, SUTE 124
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4004
Practice Address - Country:US
Practice Address - Phone:757-227-3076
Practice Address - Fax:757-227-3212
Is Sole Proprietor?:No
Enumeration Date:2011-05-29
Last Update Date:2011-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002133101YM0800X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral