Healthcare Provider Details

I. General information

NPI: 1811803513
Provider Name (Legal Business Name): KAMRYN HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 CLARK ST
GROVE HILL AL
36451-3050
US

IV. Provider business mailing address

PO BOX 964
MONROEVILLE AL
36461-0964
US

V. Phone/Fax

Practice location:
  • Phone: 251-575-4203
  • Fax: 251-575-9459
Mailing address:
  • Phone: 251-575-4203
  • Fax: 251-575-9459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: