Provider Demographics
NPI:1326688144
Name:HARRIS, PAMELA NADINE (LPC, PHD)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:NADINE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CLEMENTS MILL TRCE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5436
Mailing Address - Country:US
Mailing Address - Phone:757-880-5124
Mailing Address - Fax:
Practice Address - Street 1:12721 DARBY BROOK CT STE 102
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2408
Practice Address - Country:US
Practice Address - Phone:703-497-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional