Healthcare Provider Details

I. General information

NPI: 1841805553
Provider Name (Legal Business Name): KHELSEA HARRIS M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2020
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 MAIN ST STE 303
WEYMOUTH MA
02190-1845
US

IV. Provider business mailing address

541 MAIN ST STE 303
SOUTH WEYMOUTH MA
02190-1845
US

V. Phone/Fax

Practice location:
  • Phone: 401-419-5152
  • Fax:
Mailing address:
  • Phone: 508-203-1267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: