Provider Demographics
NPI:1467781419
Name:HARRIS, AIMEE (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-0149
Mailing Address - Country:US
Mailing Address - Phone:804-904-9731
Mailing Address - Fax:
Practice Address - Street 1:244 RIDGE WAY DR
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-8347
Practice Address - Country:US
Practice Address - Phone:804-904-9731
Practice Address - Fax:804-904-9731
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-21
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004427101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor