Provider Demographics
NPI:1336878115
Name:HARRIS-JOLLY, STEPHANIE ROWENA (LPC AND CPCS)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ROWENA
Last Name:HARRIS-JOLLY
Suffix:
Gender:F
Credentials:LPC AND CPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 N VALENCIA DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-3732
Mailing Address - Country:US
Mailing Address - Phone:229-291-4197
Mailing Address - Fax:
Practice Address - Street 1:1619 N VALENCIA DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-3732
Practice Address - Country:US
Practice Address - Phone:229-291-4197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003534101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health