Gwenetta A Harris, BS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC008226 Issued in GA

Practice address

437 W Parker St
Baxley, GA 31513-0605

Phone

(912) 705-0858

Fax

(912) 705-6423

NPI assigned

Mar 15, 2019

Last updated

Jun 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

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.

• Southern Counseling Services LLC

  dba Southern Counseling Services

  • Psychiatry Physician
  • Alma, GA
  • NPI 1578093712
  NPD (past)

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

{
    "created_epoch": "1552608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1629537097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 ALVIN OGDEN DR",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315138883",
            "telephone_number": "912-339-1423",
            "fax_number": "912-705-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 W PARKER ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130605",
            "telephone_number": "912-705-0858",
            "fax_number": "912-705-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GWENETTA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-15",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC008226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Woodruff Gruber, RN, BSN, NP-C
• Toni Hale-Tinner
• Jeanette Lynn Hale, FNP-C
• Lisa Lynn Hall
• Ashlynn Hampton
• Healthie Community Center LLC (HealtHIE Community Center of Baxley)
• Joseph C Hegarty, MD
• Patty Kristal Henry, MD
• Matthew Hodges, FNP-BC
• Bryan Lanier Holmes Sr., PHD

• Professional Counselor in Baxley, GA
• Providers in Baxley, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.