Provider Demographics
NPI:1851990725
Name:HARRIS, JENNIFER (LMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 N 145TH ST UNIT 33891
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-1138
Mailing Address - Country:US
Mailing Address - Phone:206-432-8300
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N STE 523
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8972
Practice Address - Country:US
Practice Address - Phone:206-432-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61066669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH61258289OtherWASHINGTON STATE DEPARTMENT OF HEALTH
WAMC61066669OtherWASHINGTON DEPARTMENT OF HEALTH