Healthcare Provider Details

I. General information

NPI: 1093365934
Provider Name (Legal Business Name): JAMES HARRISON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 PECAN PARK AVE STE D
ALEXANDRIA LA
71303-3362
US

IV. Provider business mailing address

415 BIENVILLE ST STE 6
NATCHITOCHES LA
71457-5700
US

V. Phone/Fax

Practice location:
  • Phone: 318-704-6157
  • Fax:
Mailing address:
  • Phone: 318-652-8140
  • Fax: 318-521-8065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8465
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: