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NPI Code Detail

MEDICARE: DR. JALANA SHEREESE HARRIS PHD, LCSW-R

MEDICARE: DR. JALANA SHEREESE HARRIS PHD, LCSW-R
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
11041C0700XClinical Social Worker081041NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467771659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JALANA SHEREESE HARRIS PHD, LCSW-R
Provider Business Mailing Address
First Line : 248-25 NORTHERN BLVD
Second Line : SUITE 1-J PMB 2022
City : LITTLE NECK
State : NY
Zip : 11362
Country : US
Telephone Number : 347-766-8788
Fax Number :
Provider Business Practice Location Address
First Line : 397 BRIDGE ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11201-5292
Country : US
Telephone Number : 347-766-8788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2010
Last Update Date : 06/21/2023

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