Provider Demographics
NPI:1932533940
Name:HARRIS, KEONA MICHELLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KEONA
Middle Name:MICHELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 OLD HOLZWARTH RD APT 101
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-4793
Mailing Address - Country:US
Mailing Address - Phone:469-263-9870
Mailing Address - Fax:
Practice Address - Street 1:2111 OLD HOLZWARTH RD APT 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-4793
Practice Address - Country:US
Practice Address - Phone:469-263-9870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65638101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health