Provider Demographics
NPI:1861297434
Name:HARRIS, AUDREY (LPC)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 ESPLANADE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-6308
Mailing Address - Country:US
Mailing Address - Phone:337-478-1411
Mailing Address - Fax:337-562-1489
Practice Address - Street 1:614 ESPLANADE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-6308
Practice Address - Country:US
Practice Address - Phone:337-478-1411
Practice Address - Fax:337-562-1489
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health