Provider Demographics
NPI:1821637075
Name:HARRIS, ADAM DAVID (MA)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:DAVID
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:828 17TH ST UNIT 809
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3154
Mailing Address - Country:US
Mailing Address - Phone:860-707-3214
Mailing Address - Fax:
Practice Address - Street 1:655 ASPEN RIDGE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-9341
Practice Address - Country:US
Practice Address - Phone:303-665-4342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health