Provider Demographics
NPI:1851049712
Name:HARRIS, LEWIS LEROY (LPC)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:LEROY
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3748 US HIGHWAY 59 N STE A
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-8981
Mailing Address - Country:US
Mailing Address - Phone:936-259-2119
Mailing Address - Fax:936-286-3106
Practice Address - Street 1:3748 US HIGHWAY 59 N STE A
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-8981
Practice Address - Country:US
Practice Address - Phone:936-259-2119
Practice Address - Fax:936-286-3106
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87808101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87808OtherSTATE LICENSE