Provider Demographics
NPI:1548599236
Name:HARRIS, NATHAN ANDREW (LICSW)
Entity Type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:ANDREW
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:206 CLARENDON ST
Mailing Address - Street 2:TRINITY BOSTON COUNSELING CENTER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-3722
Mailing Address - Country:US
Mailing Address - Phone:617-536-0944
Mailing Address - Fax:617-536-8916
Practice Address - Street 1:206 CLARENDON ST
Practice Address - Street 2:TRINITY BOSTON COUNSELING CENTER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3722
Practice Address - Country:US
Practice Address - Phone:617-536-0944
Practice Address - Fax:617-536-8916
Is Sole Proprietor?:No
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1142171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical