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General NPI Number Information
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NPI Number | 1518963149
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Entity Type | Individual
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Provider Name | KIMBERLY DENISE HARRIS LCSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 8011 BROOKS CHAPEL RD STE 3761
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City | BRENTWOOD
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State | TN
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Zip | 37027-3964
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Country | US
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Telephone | 417-312-9025
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Fax |
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Provider Business Mailing Address
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Address Line | 8011 BROOKS CHAPEL RD STE 3761
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City | BRENTWOOD
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State | TN
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Zip | 37027-3964
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Country | US
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Telephone | 417-312-9025
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8769C
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License Number State | AR
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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 | LSW0000004257
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License Number State | TN
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