NPIMap

Amanda Harrison, LPC

Individual provider Active NPI Professional Counselor · Millen, GA

NPI 1497800098 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497800098
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC003787 (GA)
Practice address
727 Virginia Avenue
Millen, GA 30442
Phone
(478) 982-2137
Fax
(478) 982-2595
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC003787GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ogeechee Behavioral Health Services Past Accepting new patients
Ogeechee Behavioral Health Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC003787 GA Yes

Addresses

Primary practice location

727 Virginia Avenue
Millen, GA 30442

Mailing address

P O Box 1259
223 N. Anderson Drive
Swainsboro, GA 30401

Other providers in Millen, GA

All providers in Millen, GA · Professional Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.