Provider Demographics
NPI:1053967372
Name:HARRIS, VERONICA CELESTE (LAPC, NCC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:CELESTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6584 SHADY CREEK CT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-3027
Mailing Address - Country:US
Mailing Address - Phone:678-549-1203
Mailing Address - Fax:
Practice Address - Street 1:6584 SHADY CREEK CT
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-3027
Practice Address - Country:US
Practice Address - Phone:678-549-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC006962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health