Provider Demographics
NPI:1275700106
Name:HARRIS, SYLVIA M (LGPC, CAC-AD)
Entity Type:Individual
Prefix:MISS
First Name:SYLVIA
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LGPC, CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18702 MARY FLOWERS WAY
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1494
Mailing Address - Country:US
Mailing Address - Phone:301-991-2855
Mailing Address - Fax:
Practice Address - Street 1:18702 MARY FLOWERS WAY
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-1494
Practice Address - Country:US
Practice Address - Phone:301-991-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP3340101YM0800X
MDAC1600101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)