Provider Demographics
NPI:1851081285
Name:HARRIS, LAEL SIMONE
Entity Type:Individual
Prefix:
First Name:LAEL
Middle Name:SIMONE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E MOUNTAIN VIEW AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3795
Mailing Address - Country:US
Mailing Address - Phone:509-825-4020
Mailing Address - Fax:
Practice Address - Street 1:401 E MOUNTAIN VIEW AVE STE 4
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3795
Practice Address - Country:US
Practice Address - Phone:509-825-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical