Provider Demographics
NPI:1689731663
Name:ALAN JAY HARRIS PHD INC
Entity Type:Organization
Organization Name:ALAN JAY HARRIS PHD INC
Other - Org Name:ALLIED PSYCHOLOGICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:904-739-3688
Mailing Address - Street 1:3716 UNIVERSITY BLVD SOUTH
Mailing Address - Street 2:STE 6
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216
Mailing Address - Country:US
Mailing Address - Phone:904-739-3688
Mailing Address - Fax:907-367-0250
Practice Address - Street 1:3716 UNIVERSITY BLVD SOUTH
Practice Address - Street 2:STE 6
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216
Practice Address - Country:US
Practice Address - Phone:904-739-3688
Practice Address - Fax:907-367-0250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003387103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty