MEDICARE: CAROLYN HARRIS

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	MH14687	FL

General Provider Information

NPI Number	:	1841692134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLYN HARRIS

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-532-0002
Fax Number	:

Provider Business Practice Location Address
First Line	:	8002 KING HELIE BLVD
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-1435
Country	:	US
Telephone Number	:	727-281-3350
Fax Number	:

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

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	03/16/2026

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