Active NPI
D'Anthony Teon Harris
- Professional Counselor
- Conyers, GA
National Provider Identifier
1295361673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC011076
- 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, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LPC011076 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interlinked Counseling and Consulting Services LLC | Current | 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.
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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.