Provider Demographics
NPI:1750429361
Name:HARRIS, LARRY H (LPCC)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:H
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18978 MERCER RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9244
Mailing Address - Country:US
Mailing Address - Phone:419-353-1401
Mailing Address - Fax:419-354-2465
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:SUITE #218
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2975
Practice Address - Country:US
Practice Address - Phone:419-494-4910
Practice Address - Fax:419-354-2465
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002175101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health