Provider Demographics
NPI:1568008688
Name:HARRIS, POLINA KITSIS (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:POLINA
Middle Name:KITSIS
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5557 HOBART ST APT 14
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1989
Mailing Address - Country:US
Mailing Address - Phone:440-342-6903
Mailing Address - Fax:
Practice Address - Street 1:9401 MCKNIGHT RD STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-6000
Practice Address - Country:US
Practice Address - Phone:412-367-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-24
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012014101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional