Provider Demographics
NPI:1952583767
Name:HARRIS, NATASHA (NP CNS)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:NP CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:270 CENTER ST
Mailing Address - Street 2:WEST HAVEN MENTAL HEALTH CENTER
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516
Mailing Address - Country:US
Mailing Address - Phone:203-974-5914
Mailing Address - Fax:203-974-5905
Practice Address - Street 1:270 CENTER ST
Practice Address - Street 2:WEST HAVEN MENTAL HEALTH CENTER
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516
Practice Address - Country:US
Practice Address - Phone:203-974-5914
Practice Address - Fax:203-974-5905
Is Sole Proprietor?:No
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003864363LP0808X, 364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent