Individual provider Active NPI

Cierra Harris

  • Professional Counselor
  • Stone Mountain, GA
National Provider Identifier
1093350761
Registry record updated Nov 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
APC007151 Issued in GA
Practice address
221 Scenic View LN
Stone Mountain, GA 30087-6193
Phone
(757) 582-1534
NPI assigned
Nov 16, 2019
Last updated
Nov 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X APC007151 GA Primary

Addresses

Primary practice location

221 Scenic View LN
Stone Mountain, GA 30087-6193

Mailing address

221 Scenic View LN
Stone Mountain, GA 30087-6193
Phone (757) 582-1534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240419000200 GA Practitioner - Mental Health Counselor 1456790732 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APC007151GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lane CurrentSince Mar 1, 2024 Accepting new patients

Locations

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

2801 Buford Hwy NE
Ste T10
Brookhaven, GA 30329
Phone (404) 397-8302

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573862400000",
    "number": "1093350761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 SCENIC VIEW LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876193",
            "telephone_number": "757-582-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 SCENIC VIEW LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876193",
            "telephone_number": "757-582-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CIERRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-16",
        "last_updated": "2019-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "APC007151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

Verify at the official NPI Registry.