Healthcare Provider Details

I. General information

NPI: 1285566406
Provider Name (Legal Business Name): ANTONIA HARRIS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WOOD ST
BELLE VERNON PA
15012-1134
US

IV. Provider business mailing address

101 WOOD ST
BELLE VERNON PA
15012-1134
US

V. Phone/Fax

Practice location:
  • Phone: 724-809-6627
  • Fax:
Mailing address:
  • Phone: 724-809-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC019160
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: