MEDICARE: MRS. ELLEN DEGRAFF HARRISON 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
1	101YM0800X	Mental Health Counselor	0701003017	VA

General Provider Information

NPI Number	:	1801894993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN DEGRAFF HARRISON LPC

Provider Business Mailing Address
First Line	:	PO BOX 2500
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24402-2500
Country	:	US
Telephone Number	:	540-332-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 RICHMOND AVE
Second Line	:
City	:	STAUNTON
State	:	VA
Zip	:	24401-9146
Country	:	US
Telephone Number	:	540-332-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	05/13/2013

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