Basic Information
| Provider Information | |||||||||
| NPI: | 1285123315 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | SEAN | ||||||||
| MiddleName: | REED | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 N DOBSON RD STE 15 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852244412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802828336 | ||||||||
| FaxNumber: | 4802828365 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 N DOBSON RD STE 15 | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852244412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802828336 | ||||||||
| FaxNumber: | 4802828365 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2018 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 19970 | AZ | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.