Healthcare Provider Details
I. General information
NPI: 1841019650
Provider Name (Legal Business Name): BRITTANY NICOLE HARRIS LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1345 SPACE PARK DR STE C
HOUSTON TX
77058-3469
US
IV. Provider business mailing address
1345 SPACE PARK DR STE C
HOUSTON TX
77058-3469
US
V. Phone/Fax
- Phone: 281-333-2284
- Fax: 281-333-0221
- Phone: 281-333-2284
- Fax: 281-333-0221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 95472 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: