Individual provider Active NPI

Jenny Harris

  • Marriage & Family Therapist
  • Valdosta, GA
National Provider Identifier
1922243476
Registry record updated Dec 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
001102 Issued in GA
Practice address
5239 Fortress Cir
Valdosta, GA 31605-6569
Phone
(229) 242-9255
NPI assigned
Dec 12, 2008
Last updated
Dec 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 001102 GA Primary

Addresses

Primary practice location

5239 Fortress Cir
Valdosta, GA 31605-6569

Mailing address

5239 Fortress Circle
Valdosta, GA 31605
Phone (229) 242-9255

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

State licenses

LicenseStateTypeSpecialty
001102GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pastoral Institute, Inc Marriage & Family Therapist CurrentSince Aug 27, 1999 Accepting new patients

Locations

2022 15th Ave
Columbus, GA 31901
Phone (706) 649-6500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229040000000",
    "number": "1922243476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5239 FORTRESS CIRCLE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "31605",
            "telephone_number": "229-242-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5239 FORTRESS CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316056569",
            "telephone_number": "229-242-9255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JENNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-12",
        "last_updated": "2008-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "001102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.