Provider Demographics
NPI:1598073942
Name:HARRIS, MARGUERITE L (LCSW, MFT)
Entity Type:Individual
Prefix:MS
First Name:MARGUERITE
Middle Name:L
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LINDEN OAKS
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2840
Mailing Address - Country:US
Mailing Address - Phone:585-586-1810
Mailing Address - Fax:585-586-7951
Practice Address - Street 1:100 LINDEN OAKS
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2840
Practice Address - Country:US
Practice Address - Phone:585-586-1810
Practice Address - Fax:585-586-7951
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO33077-11041C0700X
NY000440-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical