MEDICARE: FATIMA HARIS

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1477448827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA HARIS

Provider Business Mailing Address
First Line	:	360 HERMITAGE BLVD
Second Line	:
City	:	BERRYVILLE
State	:	VA
Zip	:	22611-1252
Country	:	US
Telephone Number	:	703-801-1630
Fax Number	:

Provider Business Practice Location Address
First Line	:	4155 CHAIN BRIDGE RD
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-4102
Country	:	US
Telephone Number	:	703-801-1630
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2025
Last Update Date	:	06/09/2025

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Directions to “ FATIMA HARIS ” Practice Location

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