Provider Demographics
NPI:1609665108
Name:HARRIS, MAKAYLA I'SHEA
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:I'SHEA
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S EAST ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-2369
Mailing Address - Country:US
Mailing Address - Phone:919-424-8084
Mailing Address - Fax:919-424-8084
Practice Address - Street 1:219 S EAST ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27601-2369
Practice Address - Country:US
Practice Address - Phone:919-424-8084
Practice Address - Fax:919-424-8084
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0218201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical