Provider Demographics
NPI:1669763355
Name:HARRIS, ALLEN RAY (LPCMHC)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:RAY
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LPCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 VERSAILLES CT
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5546
Mailing Address - Country:US
Mailing Address - Phone:302-838-5171
Mailing Address - Fax:
Practice Address - Street 1:161 VERSAILLES CT
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5546
Practice Address - Country:US
Practice Address - Phone:302-838-5171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000505101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health