Provider Demographics
NPI:1356673156
Name:HARRIS, TIFFANY N (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:N
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-4907
Mailing Address - Country:US
Mailing Address - Phone:774-392-6006
Mailing Address - Fax:
Practice Address - Street 1:34 MAIN STREET EXT
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-8302
Practice Address - Country:US
Practice Address - Phone:508-830-0012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9134101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health