MEDICARE: ERICA 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	390200000X	Student in an Organized Health Care Education/Training Program
2	101YP2500X	Professional Counselor	LPC-20085	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1972924454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA HARRIS

Provider Business Mailing Address
First Line	:	3101 N CENTRAL AVE STE 550
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85012-2635
Country	:	US
Telephone Number	:	602-230-7373
Fax Number	:	602-682-7455

Provider Business Practice Location Address
First Line	:	340 E PALM LN STE 255
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-4604
Country	:	US
Telephone Number	:	602-918-3664
Fax Number	:	480-681-1916

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

Provider Enumeration Date	:	12/30/2013
Last Update Date	:	07/21/2025

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