Provider Demographics
NPI:1245408962
Name:HARRIS, LYNDA JEAN (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:JEAN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PINE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-5331
Mailing Address - Country:US
Mailing Address - Phone:716-487-2070
Mailing Address - Fax:
Practice Address - Street 1:500 PINE ST STE 3
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-5331
Practice Address - Country:US
Practice Address - Phone:716-487-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR019769-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical