Provider Demographics
NPI:1497483838
Name:HARRIS, JILL (MA, LPC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1672 S 48TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762
Mailing Address - Country:US
Mailing Address - Phone:479-202-6300
Mailing Address - Fax:479-202-6300
Practice Address - Street 1:1672 S 48TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-202-6300
Practice Address - Fax:479-202-6300
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP2510017101YP2500X
TX64606101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional