Provider Demographics
NPI:1982913802
Name:HARRIS, DAVID F (, MTS, MS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:HARRIS
Suffix:
Gender:M
Credentials:, MTS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 CHESHIRE BRIDGE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4234
Mailing Address - Country:US
Mailing Address - Phone:404-816-7171
Mailing Address - Fax:404-634-0849
Practice Address - Street 1:2215 CHESHIRE BRIDGE RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4234
Practice Address - Country:US
Practice Address - Phone:404-816-7171
Practice Address - Fax:404-634-0849
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002354101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor