Provider Demographics
NPI:1619455862
Name:HARPER, TASIA R (MS, APC, NCC)
Entity Type:Individual
Prefix:
First Name:TASIA
Middle Name:R
Last Name:HARPER
Suffix:
Gender:F
Credentials:MS, APC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 ROCKYFORD RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1348
Mailing Address - Country:US
Mailing Address - Phone:404-944-6903
Mailing Address - Fax:
Practice Address - Street 1:2050 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-3811
Practice Address - Country:US
Practice Address - Phone:678-784-4293
Practice Address - Fax:678-784-4294
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional