Healthcare Provider Details

I. General information

NPI: 1629987094
Provider Name (Legal Business Name): EMMA GRACE HARRIS M.ED, NCC, ALC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACIE HARRIS M.ED, NCC, ALC

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 N GAY ST
AUBURN AL
36830-4800
US

IV. Provider business mailing address

166 N GAY ST
AUBURN AL
36830-4800
US

V. Phone/Fax

Practice location:
  • Phone: 334-521-8725
  • Fax:
Mailing address:
  • Phone: 334-521-8725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberALC06156
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: