Provider Demographics
NPI:1588126817
Name:HARRIS, LEAH STARR (LPC)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:STARR
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:ELIZABETH
Other - Last Name:STARR HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:109 JAKE DR
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1775
Mailing Address - Country:US
Mailing Address - Phone:361-660-6456
Mailing Address - Fax:
Practice Address - Street 1:101 W COOPERATIVE WAY STE 215
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-8210
Practice Address - Country:US
Practice Address - Phone:361-660-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73814101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty