Individual provider Active NPI

D'Anthony Teon Harris

  • Professional Counselor
  • Conyers, GA
National Provider Identifier
1295361673
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC011076 Issued in GA
Practice address
1257 Commercial Dr SW Ste a
Conyers, GA 30094-5991
Phone
(770) 285-6049
Fax
(470) 207-7902
NPI assigned
Mar 18, 2020
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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 LPC011076 GA Primary

Addresses

Primary practice location

1257 Commercial Dr SW Ste a
Conyers, GA 30094-5991

Mailing address

30 Mountain Crest Dr
Oxford, GA 30054-4181
Phone (478) 918-4040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC011076GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Interlinked Counseling and Consulting Services LLC CurrentSince Nov 13, 2022 Accepting new patients
Interlinked Community Behavioral Health Services LLC Professional Current Accepting new patients

Locations

1253 Commercial Dr SW
#A
Conyers, GA 30094
Phone (404) 957-5266

1257 Commercial Dr SW
Ste A
Conyers, GA 30094
Phone (770) 285-6049

Organizations & group practices 2

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": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1295361673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 MOUNTAIN CREST DR",
            "city": "OXFORD",
            "state": "GA",
            "postal_code": "300544181",
            "telephone_number": "478-918-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 COMMERCIAL DR SW STE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945991",
            "telephone_number": "770-285-6049",
            "fax_number": "470-207-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "D'ANTHONY",
        "middle_name": "TEON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-18",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC011076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.