Provider Demographics
NPI:1063622330
Name:HARRIS, CHRISTIAN KAYLOR (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:KAYLOR
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 MAGAZINE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-1735
Mailing Address - Country:US
Mailing Address - Phone:504-237-3813
Mailing Address - Fax:
Practice Address - Street 1:4904 MAGAZINE ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-1735
Practice Address - Country:US
Practice Address - Phone:504-237-3813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA63271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical