Healthcare Provider Details

I. General information

NPI: 1295883239
Provider Name (Legal Business Name): TERRIE A HARRIS LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERRIE ANN HARRIS LPCC-S

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 KY ROUTE 3188
LANGLEY KY
41645-8910
US

IV. Provider business mailing address

348 KY ROUTE 3188
LANGLEY KY
41645-8910
US

V. Phone/Fax

Practice location:
  • Phone: 606-226-6892
  • Fax: 606-769-0868
Mailing address:
  • Phone: 606-226-6892
  • Fax: 606-285-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number104474
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: