Provider Demographics
NPI:1083944888
Name:HARPER, ALEX (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ALEX
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 TIFTON ELDORADO RD
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-9497
Mailing Address - Country:US
Mailing Address - Phone:229-391-2300
Mailing Address - Fax:229-386-7099
Practice Address - Street 1:3120 N OAK STREET EXT STE C
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-5910
Practice Address - Country:US
Practice Address - Phone:229-671-6100
Practice Address - Fax:229-671-6774
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004889104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker