MEDICARE: KRYSTLE HARRIS LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH24143	FL

General Provider Information

NPI Number	:	1972333540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTLE HARRIS LMHC

Provider Business Mailing Address
First Line	:	1430 GADSDEN HWY STE 116
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3111
Country	:	US
Telephone Number	:	941-281-5694
Fax Number	:

Provider Business Practice Location Address
First Line	:	1430 GADSDEN HWY STE 116
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-3111
Country	:	US
Telephone Number	:	941-281-5694
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	04/15/2026

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