Provider Demographics
NPI:1841773926
Name:HARRISON, CARLA NADINE (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:NADINE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 GRANADA ST
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-3026
Mailing Address - Country:US
Mailing Address - Phone:571-306-1216
Mailing Address - Fax:240-776-4047
Practice Address - Street 1:10665 STANHAVEN PL STE 300A
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-3069
Practice Address - Country:US
Practice Address - Phone:571-306-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-13
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC11591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health