Provider Demographics
NPI:1437790896
Name:HARRIS, GAIL ARLENE (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:ARLENE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 MADERA CIR
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:MO
Mailing Address - Zip Code:64012-3344
Mailing Address - Country:US
Mailing Address - Phone:816-305-3239
Mailing Address - Fax:816-305-3239
Practice Address - Street 1:504 MADERA CIR
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:MO
Practice Address - Zip Code:64012-3344
Practice Address - Country:US
Practice Address - Phone:816-305-3239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2645101YP2500X
MO2013038263101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional