Provider Demographics
NPI:1780289710
Name:HARRIS COUNSELING AND SUPPORT SERVICES
Entity type:Organization
Organization Name:HARRIS COUNSELING AND SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-372-4346
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:SAINT HELEN
Mailing Address - State:MI
Mailing Address - Zip Code:48656-0071
Mailing Address - Country:US
Mailing Address - Phone:989-372-4346
Mailing Address - Fax:989-632-3063
Practice Address - Street 1:6482 CLEARBROOK DR
Practice Address - Street 2:
Practice Address - City:SAINT HELEN
Practice Address - State:MI
Practice Address - Zip Code:48656-9547
Practice Address - Country:US
Practice Address - Phone:989-372-4346
Practice Address - Fax:989-632-3063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2025-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1427113778Medicaid
MIMI9569OtherMEDICARE