Healthcare Provider Details

I. General information

NPI: 1629985155
Provider Name (Legal Business Name): SHEMKIA HARRIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 ENTERPRISE PATH STE 300
HIRAM GA
30141-2690
US

IV. Provider business mailing address

107 ENTERPRISE PATH STE 300
HIRAM GA
30141-2690
US

V. Phone/Fax

Practice location:
  • Phone: 770-238-6910
  • Fax:
Mailing address:
  • Phone: 770-238-6910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW007959
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: