Provider Demographics
NPI:1568609659
Name:DR. STEVEN A. HARRIS, P.C.
Entity Type:Organization
Organization Name:DR. STEVEN A. HARRIS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:616-975-0154
Mailing Address - Street 1:2618 EAST PARIS, S.E. SUITE B
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:616-622-2518
Mailing Address - Fax:616-622-2243
Practice Address - Street 1:2618 EAST PARIS, S.E. SUITE B
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546
Practice Address - Country:US
Practice Address - Phone:616-622-2518
Practice Address - Fax:616-622-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-12
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2026103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P20880OtherBCBSM 680D114410