Provider Demographics
NPI:1548810047
Name:HARRIS, HALLIE K (LCSW)
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N WABASH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-2608
Mailing Address - Country:US
Mailing Address - Phone:765-662-3971
Mailing Address - Fax:765-668-6726
Practice Address - Street 1:505 N WABASH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-2608
Practice Address - Country:US
Practice Address - Phone:765-662-3971
Practice Address - Fax:765-668-6726
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical