Provider Demographics
NPI:1235902354
Name:HARRIS, ERIC M (NAC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:M
Credentials:NAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2117 N TOWER AVE
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-3447
Mailing Address - Country:US
Mailing Address - Phone:360-506-0857
Mailing Address - Fax:
Practice Address - Street 1:2117 N TOWER AVE
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3447
Practice Address - Country:US
Practice Address - Phone:360-506-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health