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General NPI Number Information
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NPI Number | 1083782114
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Entity Type | Individual
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Provider Name | VICTORIA A HARRIS LCSW, LCAC, MSW
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 54 W BROADWAY ST STE 6
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1267
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Country | US
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Telephone | 812-345-0499
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Fax | 317-352-1510
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Provider Business Mailing Address
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Address Line | 54 W BROADWAY ST STE 6
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City | SHELBYVILLE
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State | IN
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Zip | 46176-1267
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Country | US
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Telephone | 812-345-0499
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Fax | 866-793-0495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34005767A
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License Number State | IN
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