Provider Demographics
NPI:1386881241
Name:HARRIS, CHASITY AMBER (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:CHASITY
Middle Name:AMBER
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:MRS
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC-MHSP
Mailing Address - Street 1:130 INDEPENDENCE LN
Mailing Address - Street 2:
Mailing Address - City:LA FOLLETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37766-3073
Mailing Address - Country:US
Mailing Address - Phone:423-562-1156
Mailing Address - Fax:423-562-5106
Practice Address - Street 1:130 INDEPENDENCE LN
Practice Address - Street 2:
Practice Address - City:LA FOLLETTE
Practice Address - State:TN
Practice Address - Zip Code:37766-3073
Practice Address - Country:US
Practice Address - Phone:423-562-1156
Practice Address - Fax:423-566-5106
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC2418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health