Healthcare Provider Details

I. General information

NPI: 1245774538
Provider Name (Legal Business Name): LAJOY HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2016
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3238 S LECANTO HWY
LECANTO FL
34461-9025
US

IV. Provider business mailing address

PO BOX 491000
LEESBURG FL
34749-1000
US

V. Phone/Fax

Practice location:
  • Phone: 352-632-4500
  • Fax:
Mailing address:
  • Phone: 313-671-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401015460
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH27353
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: