Provider Demographics
NPI:1851613756
Name:HARRIS, TONYA CAMPBELL (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:CAMPBELL
Last Name:HARRIS
Suffix:
Gender:F
Credentials: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 41
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-0041
Mailing Address - Country:US
Mailing Address - Phone:912-682-8451
Mailing Address - Fax:
Practice Address - Street 1:432 N ROUNTREE ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-3702
Practice Address - Country:US
Practice Address - Phone:912-682-8451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-18
Last Update Date:2019-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional