Active NPI
Miranda Harris
- Marriage & Family Therapist
- Fort Wayne, IN
National Provider Identifier
1013620566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 35002269A
- Practice address
- 9417 Saint Joe Rd
Fort Wayne, IN 46835-9474 - Phone
- (260) 370-6573
- NPI assigned
- Dec 29, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 35002269A | IN | Primary |
Addresses
Primary practice location
9417 Saint Joe Rd
Fort Wayne, IN 46835-9474
Mailing address
6424 Spy Glass Run
Fort Wayne, IN 46804-4232
Other practice location 1
5335 Bass Rd
Fort Wayne, IN 46808-2970
Phone (260) 432-0000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35002269A | IN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1672272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1672272000000",
"number": "1013620566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6424 SPY GLASS RUN",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468044232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9417 SAINT JOE RD",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468359474",
"telephone_number": "260-370-6573"
}
],
"practiceLocations": [
{
"address_1": "5335 Bass Rd",
"address_purpose": "LOCATION",
"city": "Fort Wayne",
"state": "IN",
"postal_code": "468082970",
"country_code": "US",
"telephone_number": "260-432-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "MIRANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-12-29",
"last_updated": "2022-12-29",
"certification_date": "2022-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IN",
"license": "35002269A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.