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NPI Code Detail

MEDICARE: EBONIE BRIANA HARRIS LPC

MEDICARE: EBONIE BRIANA HARRIS LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC013654GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1053406622OTHERGADRIVERS LICENSE

General Provider Information

NPI Number : 1437610045
Entity Type Code : Individual
Provider Name (Legal Business Name) : EBONIE BRIANA HARRIS LPC
Provider Business Mailing Address
First Line : 3633 WHEELER RD UNIT 365
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6549
Country : US
Telephone Number : 706-432-6866
Fax Number : 706-432-8775
Provider Business Practice Location Address
First Line : 3633 WHEELER RD UNIT 365
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6549
Country : US
Telephone Number : 706-432-6866
Fax Number : 706-432-8775
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 12/16/2025

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Directions to “ EBONIE BRIANA HARRIS LPC” Practice Location

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