Provider Demographics
NPI:1962595579
Name:HARRIS, ANNE MARIE (LMHP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 W. STOLLEY PARK ROAD
Mailing Address - Street 2:APT. 65
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-7248
Mailing Address - Country:US
Mailing Address - Phone:308-389-4647
Mailing Address - Fax:
Practice Address - Street 1:312 N. ELM
Practice Address - Street 2:SUITE 122
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-7248
Practice Address - Country:US
Practice Address - Phone:308-389-9181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2476101YM0800X
NE1345101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE243207OtherMIDLANDS CHOICE
NE10025065000Medicaid
NE84882OtherBCBS