Provider Demographics
NPI:1760900021
Name:HARRIS, CAWANNA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:CAWANNA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2329
Mailing Address - Country:US
Mailing Address - Phone:412-221-3302
Mailing Address - Fax:
Practice Address - Street 1:437 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2329
Practice Address - Country:US
Practice Address - Phone:412-221-3302
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional