Provider Demographics
NPI:1568635407
Name:HARRIS, HARLAND CLAY (LPC/MHSP SUPERVISOR)
Entity type:Individual
Prefix:
First Name:HARLAND
Middle Name:CLAY
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LPC/MHSP SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3441 MILFORD DR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-1523
Mailing Address - Country:US
Mailing Address - Phone:615-766-0218
Mailing Address - Fax:
Practice Address - Street 1:3441 MILFORD DR
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-1523
Practice Address - Country:US
Practice Address - Phone:615-766-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61480101YM0800X, 101YP2500X
TN2565101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192286602Medicaid
TX192286601Medicaid