Provider Demographics
NPI:1750975793
Name:HARRIS MENTAL HEALTH PLLC
Entity type:Organization
Organization Name:HARRIS MENTAL HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / RENDERING PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:910-398-0188
Mailing Address - Street 1:6901 THREE BRIDGES CIR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3552
Mailing Address - Country:US
Mailing Address - Phone:910-398-0188
Mailing Address - Fax:814-377-0185
Practice Address - Street 1:6901 THREE BRIDGES CIR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-3552
Practice Address - Country:US
Practice Address - Phone:910-398-0188
Practice Address - Fax:814-377-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-20
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1003353954Medicaid
PA1154831576Medicaid