Provider Demographics
NPI:1982962502
Name:HARRIS, BRANDI NIKO'L (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:NIKO'L
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 REEFTON RD
Mailing Address - Street 2:APT 204
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8219
Mailing Address - Country:US
Mailing Address - Phone:704-807-6127
Mailing Address - Fax:
Practice Address - Street 1:1820 REEFTON RD
Practice Address - Street 2:APT 204
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8219
Practice Address - Country:US
Practice Address - Phone:704-807-6127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0076261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical