Provider Demographics
NPI:1154607737
Name:HARRIS, DAVID M (MSW, LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7750 CLAYTON RD STE 220
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1342
Mailing Address - Country:US
Mailing Address - Phone:314-260-6680
Mailing Address - Fax:314-260-6673
Practice Address - Street 1:7750 CLAYTON RD STE 220
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1342
Practice Address - Country:US
Practice Address - Phone:314-260-6680
Practice Address - Fax:314-260-6673
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20060240181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical