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General NPI Number Information
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NPI Number | 1811003932
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Entity Type | Individual
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Provider Name | ELEANOR JOYCE HARRIS MSW
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 350 S BURDICK MALL SUITE 236 LETS TALK ABOUT IT COMM MENTAL HEALTH SERVICE
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City | KALAMAZOO
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State | MI
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Zip | 49007
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Country | US
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Telephone | 269-567-9409
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Fax | 269-329-4077
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Provider Business Mailing Address
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Address Line | 7663 N GLENEAGLE DR
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City | KALAMAZOO
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State | MI
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Zip | 49048-8614
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Country | US
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Telephone | 269-377-7493
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Fax | 269-342-5083
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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 | 6801010668
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License Number State | MI
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