Provider Demographics
NPI:1235789892
Name:HARRIS, KRISTIE N (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:N
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MISS
Other - First Name:KRISTIE
Other - Middle Name:
Other - Last Name:MAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9920 NE 202ND ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-2340
Mailing Address - Country:US
Mailing Address - Phone:062-909-2882
Mailing Address - Fax:
Practice Address - Street 1:26420 NE VIRGINIA ST STE 2
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5801
Practice Address - Country:US
Practice Address - Phone:425-844-9669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAMC6063642101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health