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General NPI Number Information
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NPI Number | 1477769693
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Entity Type | Individual
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Provider Name | TERESA ANN HARRIS LMHC PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 130 S MASSACHUSETTS AVE STE 803
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City | LAKELAND
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State | FL
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Zip | 33801-5031
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Country | US
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Telephone | 727-200-2310
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Fax | 727-499-5311
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Provider Business Mailing Address
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Address Line | 130 S MASSACHUSETTS AVE FL 33801
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City | LAKELAND
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State | FL
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Zip | 33801-5003
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Country | US
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Telephone | 727-200-2310
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Fax | 727-499-5311
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH5429
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5429
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License Number State | FL
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