Provider Demographics
NPI:1134237209
Name:HARRIS, KAREN V (LCSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:V
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 E OGLETHORPE HWY
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-1200
Mailing Address - Country:US
Mailing Address - Phone:912-368-3502
Mailing Address - Fax:912-368-6844
Practice Address - Street 1:1113 OGLETHORPE HWY
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313
Practice Address - Country:US
Practice Address - Phone:912-368-3502
Practice Address - Fax:912-368-6844
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003400A1041C0700X
GACSW0040621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical