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General NPI Number Information
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NPI Number | 1962285536
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Entity Type | Individual
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Provider Name | PATRICK BRIAN HARRIS MA
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Gender | Male
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 436 BROAD ST
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City | ROME
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State | GA
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Zip | 30161-3054
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Country | US
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Telephone | 706-766-1105
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Fax |
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Provider Business Mailing Address
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Address Line | 6 EASTRIDGE CT SW
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City | ROME
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State | GA
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Zip | 30161-6137
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Country | US
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Telephone | 706-766-1105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LPC015114
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC008138
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License Number State | GA
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