Provider Demographics
NPI:1861529463
Name:HARRIS, MEGAN EMILY (LCSW)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:EMILY
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-0964
Mailing Address - Country:US
Mailing Address - Phone:925-978-3212
Mailing Address - Fax:
Practice Address - Street 1:18 BRYSON DR
Practice Address - Street 2:
Practice Address - City:SUTTER CREEK
Practice Address - State:CA
Practice Address - Zip Code:95685-4118
Practice Address - Country:US
Practice Address - Phone:209-498-8033
Practice Address - Fax:209-217-8312
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2021-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA804921041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical