Provider Demographics
NPI:1780490342
Name:HARRIS, NATALIE SUZANNE (LCSW-A)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:SUZANNE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5664
Mailing Address - Country:US
Mailing Address - Phone:910-987-0777
Mailing Address - Fax:
Practice Address - Street 1:351 WAGONER DR STE 324
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4671
Practice Address - Country:US
Practice Address - Phone:910-977-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0215351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical