Provider Demographics
NPI:1811003932
Name:HARRIS, ELEANOR JOYCE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ELEANOR
Middle Name:JOYCE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7663 N GLENEAGLE DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-8614
Mailing Address - Country:US
Mailing Address - Phone:269-377-7493
Mailing Address - Fax:269-342-5083
Practice Address - Street 1:350 S BURDICK MALL
Practice Address - Street 2:SUITE 236 LETS TALK ABOUT IT COMM MENTAL HEALTH SERVICE
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007
Practice Address - Country:US
Practice Address - Phone:269-567-9409
Practice Address - Fax:269-329-4077
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010106681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical