Healthcare Provider Details

I. General information

NPI: 1891560132
Provider Name (Legal Business Name): CHRISTIAN HARRIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 NEW YORK AVE NE
WASHINGTON DC
20002-3320
US

IV. Provider business mailing address

64 NEW YORK AVE NE
WASHINGTON DC
20002-3320
US

V. Phone/Fax

Practice location:
  • Phone: 888-793-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25891
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: