Provider Demographics
NPI:1700054004
Name:HARRIS, TORI L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TORI
Middle Name:L
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1569 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JAY
Mailing Address - State:OK
Mailing Address - Zip Code:74346-2903
Mailing Address - Country:US
Mailing Address - Phone:918-253-1900
Mailing Address - Fax:
Practice Address - Street 1:61900 E 220 RD
Practice Address - Street 2:
Practice Address - City:FAIRLAND
Practice Address - State:OK
Practice Address - Zip Code:74343-2270
Practice Address - Country:US
Practice Address - Phone:918-801-6468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK26601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical