Healthcare Provider Details

I. General information

NPI: 1063060093
Provider Name (Legal Business Name): SHARESE ANN BAILEY HARRIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4786 W COUNTRY SKY DR
TUCSON AZ
85742-4541
US

IV. Provider business mailing address

4786 W COUNTRY SKY DR
TUCSON AZ
85742-4541
US

V. Phone/Fax

Practice location:
  • Phone: 334-224-2013
  • Fax:
Mailing address:
  • Phone: 520-979-3482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-20845
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: