Provider Demographics
NPI:1821985573
Name:HARRIS, TASHEEN LOUISE
Entity type:Individual
Prefix:
First Name:TASHEEN
Middle Name:LOUISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 S HARRISON ST APT 12J
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-1620
Mailing Address - Country:US
Mailing Address - Phone:347-551-6698
Mailing Address - Fax:
Practice Address - Street 1:141 S HARRISON ST APT 12J
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1620
Practice Address - Country:US
Practice Address - Phone:347-551-6698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1003041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical