Provider Demographics
NPI:1598513392
Name:HARDEN, SHERISE HARDEN (MS, MS)
Entity type:Individual
Prefix:MRS
First Name:SHERISE
Middle Name:HARDEN
Last Name:HARDEN
Suffix:
Gender:F
Credentials:MS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 INTERNATIONAL BLVD
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6087
Mailing Address - Country:US
Mailing Address - Phone:706-631-2049
Mailing Address - Fax:
Practice Address - Street 1:111 INTERNATIONAL BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6087
Practice Address - Country:US
Practice Address - Phone:706-631-2049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst