Provider Demographics
NPI:1518712074
Name:HARRY, JAIME LAUREN (LCSW)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:LAUREN
Last Name:HARRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 TEMPLETON DR # NA
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-5768
Mailing Address - Country:US
Mailing Address - Phone:972-804-0664
Mailing Address - Fax:
Practice Address - Street 1:2207 TEMPLETON DR # NA
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-5768
Practice Address - Country:US
Practice Address - Phone:972-804-0664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX604821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical