Provider Demographics
NPI:1205648060
Name:HARRISON, FLOYD (LSSP)
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:
Last Name:HARRISON
Suffix:
Gender:M
Credentials:LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5118 WESTERHAM PL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2041
Mailing Address - Country:US
Mailing Address - Phone:281-241-7446
Mailing Address - Fax:
Practice Address - Street 1:5118 WESTERHAM PL
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2041
Practice Address - Country:US
Practice Address - Phone:281-241-7446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34312103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool