Provider Demographics
NPI:1902681224
Name:HARRIS, SANDRA ARNETTE (LPC-A)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ARNETTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 MEDICAL DISTRICT DR APT 1078
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-8085
Mailing Address - Country:US
Mailing Address - Phone:347-944-4118
Mailing Address - Fax:
Practice Address - Street 1:1910 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4529
Practice Address - Country:US
Practice Address - Phone:214-643-6820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-25
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health