Provider Demographics
NPI:1407099344
Name:HARRISON, KATHRYN DAILEY (LPC, MHSP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:DAILEY
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LPC, MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 POPLAR VIEW LN W
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3175
Mailing Address - Country:US
Mailing Address - Phone:901-853-2743
Mailing Address - Fax:901-854-8595
Practice Address - Street 1:311 POPLAR VIEW LN W
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3175
Practice Address - Country:US
Practice Address - Phone:901-853-2743
Practice Address - Fax:901-854-8595
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN802101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional