Healthcare Provider Details

I. General information

NPI: 1801394044
Provider Name (Legal Business Name): RHONDA KENNEDY HARRIS, LPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2018
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 AVENUE OF AMERICA
MONROE LA
71201
US

IV. Provider business mailing address

116 BURNSIDE DR
TALLULAH LA
71282-5506
US

V. Phone/Fax

Practice location:
  • Phone: 318-998-2700
  • Fax: 318-998-2703
Mailing address:
  • Phone: 318-341-8558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2930
License Number StateLA

VIII. Authorized Official

Name: MRS. RHONDA HARRIS
Title or Position: OWNER
Credential: LPC
Phone: 318-341-8558