Lauren Evelyn Reba-Harrelson, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY003563 Issued in GA

Practice address

507 Harper Rd
McDonough, GA 30252-4958

Phone

(919) 923-2119

NPI assigned

Nov 15, 2018

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

Other names 1

• Lauren E Reba-Harrelson Other name

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1700355179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 HARPER RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302524958",
            "telephone_number": "919-923-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HARPER RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302524958",
            "telephone_number": "919-923-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBA-HARRELSON",
        "first_name": "LAUREN",
        "middle_name": "EVELYN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-15",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY003563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "REBA-HARRELSON",
            "middle_name": "E",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Marilyn Rankin, NP
• Gopal C Rao, MD
• Daphne Michelle Ray-Leverett, FNP
• Hansel M Rayner, PA-C
• Travis Ready, PHARMD
• Rebound Integrative Medical Group Psychiatry
• Destiny Redding, DMD
• Evelyn O'Leary Redding, FNP-C
• Rajasekhar Reddy, M.D.
• Haley Reed, LPC, NCC

• Clinical Psychologist in McDonough, GA
• Providers in McDonough, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.