Provider Demographics
NPI:1326745266
Name:HARRISON, CHANDRA B (MS, NCC)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:B
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:B
Other - Last Name:LUKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:787 BACON AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-2506
Mailing Address - Country:US
Mailing Address - Phone:302-535-5805
Mailing Address - Fax:
Practice Address - Street 1:111 W MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1018
Practice Address - Country:US
Practice Address - Phone:302-725-3120
Practice Address - Fax:302-204-1248
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health