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General NPI Number Information
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NPI Number | 1710191994
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Entity Type | Organization
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Legal Business Name | ANDRA HARRIS-MARTIN, LPC, LLC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5755 N POINT PKWY SUITE 65
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City | ALPHARETTA
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State | GA
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Zip | 30022-1142
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Country | US
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Telephone | 678-624-1707
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Fax |
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Provider Business Mailing Address
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Address Line | 5755 N POINT PKWY SUITE 65
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City | ALPHARETTA
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State | GA
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Zip | 30022-1142
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Country | US
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Telephone | 678-624-1707
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | ANDRA HARRIS-MARTIN
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Credential | ED.S., LPC, NCC
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Telephone | 678-624-1707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 003558
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License Number State | GA
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