Provider Demographics
NPI:1790398303
Name:HARRIS, LOGAN DELANEY (LSW, BSW)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:DELANEY
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LSW, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N 3RD ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-5550
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 N 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-5550
Practice Address - Country:US
Practice Address - Phone:740-349-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker