Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 1159 | MS |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 1159 | MS |
N | 101YM0800X | Mental Health Counselor | 1159 | MS |
N | 101YP1600X | Pastoral Counselor | 1159 | MS |
Y | 101YP2500X | Professional Counselor | 1159 | MS |
N | 101YS0200X | School Counselor | 1159 | MS |
NPI | 1053795799 |
---|---|
Provider Name | Dr. Lorita Harris |
First Address | Cleveland, MS 38732-9545 |
Second Address | Cleveland, MS 38732-9545 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2015 |
Last Update Date | 13/07/2015 |