Provider Demographics
NPI:1013785906
Name:HARRIS, DONDRE (MSW, SCW)
Entity Type:Individual
Prefix:
First Name:DONDRE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MSW, SCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16302 E 49TH AVE APT D205
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5632
Mailing Address - Country:US
Mailing Address - Phone:773-354-0011
Mailing Address - Fax:
Practice Address - Street 1:16302 E 49TH AVE APT D205
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5632
Practice Address - Country:US
Practice Address - Phone:773-354-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSWC.00000010961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical