Provider Demographics
NPI:1356185151
Name:HARRISON, HEATHER MARIE (LCSW-S)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MARIE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4023
Mailing Address - Country:US
Mailing Address - Phone:214-649-7962
Mailing Address - Fax:
Practice Address - Street 1:552 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4023
Practice Address - Country:US
Practice Address - Phone:214-649-7962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX571791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical