Healthcare Provider Details

I. General information

NPI: 1669191466
Provider Name (Legal Business Name): HANNAH HARRIS LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N MAIN ST STE 106
BRISTOL CT
06010-4993
US

IV. Provider business mailing address

225 N MAIN ST
BRISTOL CT
06010-4926
US

V. Phone/Fax

Practice location:
  • Phone: 860-793-3500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: