Provider Demographics
NPI:1972588135
Name:HARRIS, GAIL LOUISE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:GAIL
Middle Name:LOUISE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 ARTHUR GODFREY RD STE 303
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3342
Mailing Address - Country:US
Mailing Address - Phone:786-210-4814
Mailing Address - Fax:
Practice Address - Street 1:975 ARTHUR GODFREY RD STE 303
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3342
Practice Address - Country:US
Practice Address - Phone:305-864-7662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00024891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2104237 00Medicaid