Provider Demographics
NPI:1881799385
Name:HARRISON, ROBERT (LMFT)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:HARRISON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10291
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-0291
Mailing Address - Country:US
Mailing Address - Phone:865-632-5217
Mailing Address - Fax:865-549-4171
Practice Address - Street 1:200 E BLOUNT AVE
Practice Address - Street 2:#105
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1618
Practice Address - Country:US
Practice Address - Phone:865-632-5217
Practice Address - Fax:865-549-4171
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN000236OtherLICENSE