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NPI Code Detail

MEDICARE: CHRISTINA RENEE HARRIS LPC, M.ED.

MEDICARE: CHRISTINA RENEE HARRIS LPC, M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool CounselorC.1902073OH
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1245883263
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA RENEE HARRIS LPC, M.ED.
Provider Business Mailing Address
First Line : 55 E JUNIPER LN
Second Line :
City : MORELAND HILLS
State : OH
Zip : 44022-1391
Country : US
Telephone Number : 440-804-6961
Fax Number :
Provider Business Practice Location Address
First Line : 24100 CHAGRIN BLVD STE 125
Second Line :
City : BEACHWOOD
State : OH
Zip : 44122-5535
Country : US
Telephone Number : 216-714-3278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 07/18/2019

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