Provider Demographics
NPI:1053815720
Name:HARRIS-SMITH, SHERRIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:
Last Name:HARRIS-SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:SHERRIE
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:112 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:TX
Mailing Address - Zip Code:76059-1202
Mailing Address - Country:US
Mailing Address - Phone:817-240-1715
Mailing Address - Fax:
Practice Address - Street 1:112 E 4TH ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:TX
Practice Address - Zip Code:76059-1202
Practice Address - Country:US
Practice Address - Phone:817-240-1715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX269931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical