Healthcare Provider Details

I. General information

NPI: 1710757133
Provider Name (Legal Business Name): NAKIA HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2024
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7326 W GREENFIELD AVE
WEST ALLIS WI
53214-4729
US

IV. Provider business mailing address

7326 W GREENFIELD AVE
WEST ALLIS WI
53214-4729
US

V. Phone/Fax

Practice location:
  • Phone: 262-450-5633
  • Fax:
Mailing address:
  • Phone: 262-450-5633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8449-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: