Healthcare Provider Details

I. General information

NPI: 1427113778
Provider Name (Legal Business Name): HOLLY JEAN HARRIS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6482 CLEARBROOK DR
SAINT HELEN MI
48656-9547
US

IV. Provider business mailing address

PO BOX 71
SAINT HELEN MI
48656-0071
US

V. Phone/Fax

Practice location:
  • Phone: 989-372-4346
  • Fax: 989-632-3063
Mailing address:
  • Phone: 989-372-4346
  • Fax: 989-632-3063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801088117
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: