Provider Demographics
NPI:1225572142
Name:HARRIS, TAMERI (LGSW CSC-AD)
Entity Type:Individual
Prefix:MS
First Name:TAMERI
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LGSW CSC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 TEACHER CT
Mailing Address - Street 2:APT. E
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2077
Mailing Address - Country:US
Mailing Address - Phone:443-625-7645
Mailing Address - Fax:
Practice Address - Street 1:3 TEACHER CT
Practice Address - Street 2:APT. E
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2077
Practice Address - Country:US
Practice Address - Phone:443-625-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC2052101YA0400X
MD21393104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)