Provider Demographics
NPI:1598000226
Name:HARRISON, STEPHANIE S (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:HARRISON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-0206
Mailing Address - Country:US
Mailing Address - Phone:256-483-2760
Mailing Address - Fax:256-247-7018
Practice Address - Street 1:16053 HIGHWAY 72
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652-8141
Practice Address - Country:US
Practice Address - Phone:256-483-2760
Practice Address - Fax:256-247-7018
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3043101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional