Provider Demographics
NPI:1467640730
Name:HARRIS, CATHY (LMSW)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-397-1013
Mailing Address - Fax:
Practice Address - Street 1:198 MAIN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:NY
Practice Address - Zip Code:12197-1900
Practice Address - Country:US
Practice Address - Phone:607-397-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker