Provider Demographics
NPI:1629758487
Name:HARRIS, TERCEL DEVANTE (PLPC)
Entity Type:Individual
Prefix:MR
First Name:TERCEL
Middle Name:DEVANTE
Last Name:HARRIS
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 MILLERVILLE RD APT 3300
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-0103
Mailing Address - Country:US
Mailing Address - Phone:318-880-8649
Mailing Address - Fax:
Practice Address - Street 1:8211 SUMMA AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3471
Practice Address - Country:US
Practice Address - Phone:225-761-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9668101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health