Kelly M Harris, LPC, NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC009410 Issued in GA

Practice address

2531 Briarcliff Rd NE Ste 203
Atlanta, GA 30329-3017

Phone

(678) 849-4777

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 13, 2024 through Mar 13, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Renewed & Restored LLC

  • Adult Mental Health Clinic/Center
  • Atlanta, GA
  • NPI 1043834724
  NPD Authorized official

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1477199057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2218 RUGBY AVE",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303371019",
            "telephone_number": "678-849-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 BRIARCLIFF RD NE STE 203",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293017",
            "telephone_number": "678-849-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC009410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnny Harris II, M.D.
• Julia Nancy Harris
• Kai-McKenzie Harris, LCSW
• Kamaria Harris
• Katie Harris, OD
• Kevin Harris, MD
• Kim Michelle Harris
• Kim Sturdivant Harris, NP
• Kiyana Elizabeth Harris, DO
• Kyri Harris, LPC

• Mental Health Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.