Active NPI
Heather Ann Harrison, PH.D.
- Psychologist
- Kings Bay, GA
National Provider Identifier
1730778705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2052
- Practice address
- Naval Branch Health Clinic
881 Uss James Madison Road
Kings Bay, GA 31547 - Phone
- (912) 573-4215
- NPI assigned
- Jan 14, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2052 | GA | Primary |
Addresses
Primary practice location
Naval Branch Health Clinic
881 Uss James Madison Road
Kings Bay, GA 31547
Mailing address
41 E Gate Dr
Thomasville, GA 31757-4201
Phone (229) 221-2010
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2052 | GA | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610582400000",
"number": "1730778705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 E GATE DR",
"city": "THOMASVILLE",
"state": "GA",
"postal_code": "317574201",
"telephone_number": "229-221-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL BRANCH HEALTH CLINIC",
"address_2": "881 USS JAMES MADISON ROAD",
"city": "KINGS BAY",
"state": "GA",
"postal_code": "31547",
"telephone_number": "912-573-4215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "HEATHER",
"middle_name": "ANN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-14",
"last_updated": "2021-01-14",
"certification_date": "2021-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "GA",
"license": "2052",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kings Bay, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.