Provider Demographics
NPI:1992139505
Name:HARRIS, JOHANNA ELIZABETH (LPC)
Entity type:Individual
Prefix:MISS
First Name:JOHANNA
Middle Name:ELIZABETH
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 1:5472 SHIREWICK LN
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3872
Mailing Address - Country:US
Mailing Address - Phone:678-270-6712
Mailing Address - Fax:888-288-5302
Practice Address - Street 1:235 PEACHTREE ST NE STE 400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1400
Practice Address - Country:US
Practice Address - Phone:678-270-6712
Practice Address - Fax:888-288-5302
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-30
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional