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General NPI Number Information
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NPI Number | 1255371142
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Entity Type | Individual
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Provider Name | JAMES LOUIS HARRISON III MS, CSAC, LPC, NCGC-
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 15350 W NATIONAL AVE STE 108
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City | NEW BERLIN
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State | WI
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Zip | 53151-5158
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Country | US
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Telephone | 262-249-6565
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Fax | 262-910-5477
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Provider Business Mailing Address
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Address Line | 10012 WEST CAPITOL DRIVE, SUITE 101 WEST GROVE CLINIC, LLC
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City | WAUWATOSA
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State | WI
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Zip | 53222
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Country | US
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Telephone | 414-810-4844
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Fax | 414-810-4845
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 13018
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License Number State | WI
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