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General NPI Number Information
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NPI Number | 1124614599
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Entity Type | Individual
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Provider Name | JAMIE RAE HARRIS LCPC
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Gender | Female
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 5600 N RIDGE AVE UNIT 105
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City | CHICAGO
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State | IL
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Zip | 60660-0097
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Country | US
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Telephone | 773-572-9534
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Fax | 773-249-1300
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Provider Business Mailing Address
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Address Line | 4520 N CLARENDON AVE APT 605
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City | CHICAGO
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State | IL
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Zip | 60640-7275
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Country | US
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Telephone | 608-397-2669
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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 |
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License Number State | IL
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