Provider Demographics
NPI:1407988934
Name:HARRIS, GAIL R (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:R
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29216
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30359-0216
Mailing Address - Country:US
Mailing Address - Phone:678-637-1444
Mailing Address - Fax:
Practice Address - Street 1:3033 N DECATUR RD
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:GA
Practice Address - Zip Code:30079-1143
Practice Address - Country:US
Practice Address - Phone:678-637-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003387101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional