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General NPI Number Information
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NPI Number | 1487469607
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Entity Type | Individual
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Provider Name | KARA HARRISON COUNSELING RESIDENT
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 4410 CLAIBORNE SQ E STE 334
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City | HAMPTON
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State | VA
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Zip | 23666-2074
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Country | US
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Telephone | 757-895-7953
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Fax |
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Provider Business Mailing Address
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Address Line | 104 MALLARD DR
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City | SUFFOLK
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State | VA
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Zip | 23434-8093
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Country | US
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Telephone | 423-946-5042
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0704017625
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License Number State | VA
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