Provider Demographics
NPI:1174118640
Name:HARRIS, YVETTE M (QMHP, MA, CADC)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:F
Credentials:QMHP, MA, CADC
Other - Prefix:
Other - First Name:GLOBAL
Other - Middle Name:MINDED
Other - Last Name:GOALS/ GLOBAL KEYS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QMHP, MA, CADC
Mailing Address - Street 1:4843 LEDURA RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7253
Mailing Address - Country:US
Mailing Address - Phone:757-639-1194
Mailing Address - Fax:
Practice Address - Street 1:4843 LEDURA RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7253
Practice Address - Country:US
Practice Address - Phone:757-639-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAH1911191434101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)