Provider Demographics
NPI:1225645005
Name:MIKAYLA HARPER, LLC
Entity Type:Organization
Organization Name:MIKAYLA HARPER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIKAYLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:843-532-2816
Mailing Address - Street 1:3326 TABARD RD
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-8275
Mailing Address - Country:US
Mailing Address - Phone:843-532-2816
Mailing Address - Fax:
Practice Address - Street 1:452 FOLLY RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2641
Practice Address - Country:US
Practice Address - Phone:843-532-2816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)