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NPI Code Detail

MEDICARE: TERA HARRIS LPC

MEDICARE: TERA HARRIS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor0701007163VA
2101YP2500XProfessional Counselor0701007163VA
3101YP2500XProfessional Counselor
4101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205300282
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERA HARRIS LPC
Provider Business Mailing Address
First Line : 6603 IRONGATE SQ STE A
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23234-6081
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6603 IRONGATE SQ STE A
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23234-6081
Country : US
Telephone Number : 804-743-0960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2019
Last Update Date : 11/27/2023

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Directions to “ TERA HARRIS LPC” Practice Location

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