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General NPI Number Information
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NPI Number | 1225261951
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN HARRIS LCSW, LADC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 609 W JOHNSON AVE STE 310
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City | CHESHIRE
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State | CT
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Zip | 06410-4505
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Country | US
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Telephone | 203-600-2951
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Fax |
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Provider Business Mailing Address
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Address Line | 51 CHESHIRE RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-3025
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Country | US
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Telephone | 203-600-2951
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 001341
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 011409
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License Number State | CT
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