Provider Demographics
NPI:1811557598
Name:HARRELL, MAURICE D (MA, CSAC,)
Entity Type:Individual
Prefix:MS
First Name:MAURICE
Middle Name:D
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MA, CSAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CRUTCHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4208
Mailing Address - Country:US
Mailing Address - Phone:757-324-0221
Mailing Address - Fax:
Practice Address - Street 1:2021 CUNNINGHAM DR STE 400
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3371
Practice Address - Country:US
Practice Address - Phone:757-868-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty