Provider Demographics
NPI:1104561034
Name:HARMON, LINDA MARIA (LPC, LPMT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIA
Last Name:HARMON
Suffix:
Gender:F
Credentials:LPC, LPMT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MARIA
Other - Last Name:KIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:6221 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-3425
Mailing Address - Country:US
Mailing Address - Phone:478-231-0212
Mailing Address - Fax:
Practice Address - Street 1:1826 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-3620
Practice Address - Country:US
Practice Address - Phone:478-231-0212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011681101YP2500X
GAMUT000039225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional