Provider Demographics
NPI:1992287270
Name:HARRIS, TENNILLE (LPC, LCPC)
Entity type:Individual
Prefix:
First Name:TENNILLE
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 M ST SE STE 600
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3648
Mailing Address - Country:US
Mailing Address - Phone:202-503-4485
Mailing Address - Fax:202-503-4485
Practice Address - Street 1:100 M ST SE STE 600
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3648
Practice Address - Country:US
Practice Address - Phone:202-503-4485
Practice Address - Fax:202-503-4485
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC15373101YP2500X
MDLC12578101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional