Provider Demographics
NPI:1477769693
Name:HARRIS, TERESA ANN (LMHC PSYD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHC PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:130 S MASSACHUSETTS AVE FL 33801
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5003
Mailing Address - Country:US
Mailing Address - Phone:727-200-2310
Mailing Address - Fax:727-499-5311
Practice Address - Street 1:130 S MASSACHUSETTS AVE STE 803
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5031
Practice Address - Country:US
Practice Address - Phone:727-200-2310
Practice Address - Fax:727-499-5311
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5429101YM0800X
FL5429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health