Provider Demographics
NPI:1477215341
Name:HARRIS, MILTON DAVID III (LCPC)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:DAVID
Last Name:HARRIS
Suffix:III
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7635 CHESHAM CT
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-4457
Mailing Address - Country:US
Mailing Address - Phone:301-357-2824
Mailing Address - Fax:
Practice Address - Street 1:7635 CHESHAM CT
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-4457
Practice Address - Country:US
Practice Address - Phone:301-357-2824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP11982101YM0800X
MDLC14397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health