Provider Demographics
NPI:1164117123
Name:BYAS-HARRIS, TARITA (LMHC 'FL', NCC)
Entity type:Individual
Prefix:MRS
First Name:TARITA
Middle Name:
Last Name:BYAS-HARRIS
Suffix:
Gender:F
Credentials:LMHC 'FL', NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:32539-8330
Mailing Address - Country:US
Mailing Address - Phone:850-822-8343
Mailing Address - Fax:
Practice Address - Street 1:314 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-8330
Practice Address - Country:US
Practice Address - Phone:850-822-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-06
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH21150101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH22555OtherMENTAL HEALTH COUNSELOR