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General NPI Number Information
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NPI Number | 1104493105
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Entity Type | Individual
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Provider Name | JAMES HARRIS JR. LGPC
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Gender | Male
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 2670 CRAIN HWY STE 205
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City | WALDORF
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State | MD
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Zip | 20601-2816
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Country | US
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Telephone | 301-818-0092
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Fax |
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Provider Business Mailing Address
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Address Line | 3261 OLD WASHINGTON RD STE 3021
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City | WALDORF
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State | MD
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Zip | 20602-3229
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Country | US
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Telephone | 301-205-5979
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC16479
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License Number State | MD
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