Provider Demographics
NPI:1629589056
Name:HARRIS, ELIZABETH R (LCMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:R
Other - Last Name:MARSHALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:390 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2226
Mailing Address - Country:US
Mailing Address - Phone:802-886-4567
Mailing Address - Fax:802-886-4520
Practice Address - Street 1:167 MAIN ST STE 409
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-3111
Practice Address - Country:US
Practice Address - Phone:802-490-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
VT068.0103817101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health