Basic Information
| Provider Information | |||||||||
| NPI: | 1598014193 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRISON | ||||||||
| FirstName: | RALPH | ||||||||
| MiddleName: | THOMAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O.BOX 728 | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28779 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8285866600 | ||||||||
| FaxNumber: | 8285866601 | ||||||||
| Practice Location | |||||||||
| Address1: | 669 S. HAYWOOD ST. | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284562997 | ||||||||
| FaxNumber: | 8284562996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2012 | ||||||||
| LastUpdateDate: | 09/21/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | P007540 | NC | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | C009021 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.