Provider Demographics
NPI:1356694491
Name:HARRIS, ALISSA RENEE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:RENEE
Last Name:HARRIS
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:ALISSA
Other - Middle Name:RENEE
Other - Last Name:BLEECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:3820 PACKARD ST STE 250
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-5017
Mailing Address - Country:US
Mailing Address - Phone:734-780-7338
Mailing Address - Fax:
Practice Address - Street 1:3820 PACKARD ST STE 250
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-5017
Practice Address - Country:US
Practice Address - Phone:734-780-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010951581041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical