Provider Demographics
NPI:1851838361
Name:HARRIS, STILL RISING CONSULT (LSW, LICDC)
Entity Type:Individual
Prefix:
First Name:STILL RISING CONSULT
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LSW, LICDC
Other - Prefix:
Other - First Name:SHARRON
Other - Middle Name:J
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5958 LEAFRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7735
Mailing Address - Country:US
Mailing Address - Phone:937-450-7011
Mailing Address - Fax:
Practice Address - Street 1:1071 FISHINGER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-2356
Practice Address - Country:US
Practice Address - Phone:220-216-0621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-22
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.162385101YA0400X, 101Y00000X
OHS1200374101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator