Provider Demographics
NPI:1790026672
Name:HARRIZ, ILHAM (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ILHAM
Middle Name:
Last Name:HARRIZ
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 1:100 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1006
Mailing Address - Country:US
Mailing Address - Phone:407-245-0014
Mailing Address - Fax:
Practice Address - Street 1:100 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1006
Practice Address - Country:US
Practice Address - Phone:407-245-0014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW103131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical