Harry Scott Gordon, LPC
Individual provider Active NPI Mental Health Counselor · Atlanta, GA
NPI 1194339689 · NPPES record last updated Sep 2, 2020
Key facts
- NPI
- 1194339689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 011599 (GA)
- Practice address
- 3342 Rose RDG
Atlanta, GA 30340-4074 - Phone
- (678) 558-3930
- NPI assigned
- Sep 2, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011599 | GA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Safe Space LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 011599 | GA | Yes |
Addresses
Primary practice location
3342 Rose RDG
Atlanta, GA 30340-4074
Mailing address
3342 Rose RDG
Atlanta, GA 30340-4074
Phone (678) 558-3930
Other providers in Atlanta, GA
- Charlotta A. Gordon
- Destiny Gordon
- Donna Lipsius Gordon
- Doris S Gordon
- Haley C Gordon
- Jacqueline Sharon Gordon
- Jacques Lenoel Gordon
- Jameari Gordon
- James W Gordon
- Jennifer Gordon
All providers in Atlanta, GA · Mental Health Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.