Provider Demographics
NPI:1861832719
Name:HARRIS, COURTNEY (LPCA)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5525 HARDIE FARM DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-8284
Mailing Address - Country:US
Mailing Address - Phone:757-535-2705
Mailing Address - Fax:336-282-3430
Practice Address - Street 1:717 GREEN VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408
Practice Address - Country:US
Practice Address - Phone:336-674-9781
Practice Address - Fax:336-282-3430
Is Sole Proprietor?:No
Enumeration Date:2013-06-25
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10227101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional