Provider Demographics
NPI:1225788094
Name:CHRISTOPHER CHARLES HARRIS, PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CHRISTOPHER CHARLES HARRIS, PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-802-3945
Mailing Address - Street 1:15510 CALLAHAN
Mailing Address - Street 2:
Mailing Address - City:FRASER
Mailing Address - State:MI
Mailing Address - Zip Code:48026-2723
Mailing Address - Country:US
Mailing Address - Phone:313-802-3945
Mailing Address - Fax:
Practice Address - Street 1:15510 CALLAHAN
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:MI
Practice Address - Zip Code:48026-2723
Practice Address - Country:US
Practice Address - Phone:313-802-3945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty