Individual provider Active NPI

Dannie Harris

  • Clinical Psychologist
  • Clarksville, TN
National Provider Identifier
1033586748
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3642 Issued in TN
Practice address
1064 S Riverside Dr Ste D
Clarksville, TN 37040-4746
Phone
(931) 217-1833
NPI assigned
Aug 28, 2015
Last updated
Sep 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 246145 KY
Clinical Psychologist 103TC0700X 3642 TN Primary

Addresses

Primary practice location

1064 S Riverside Dr Ste D
Clarksville, TN 37040-4746

Mailing address

1064 S Riverside Dr Ste D
Clarksville, TN 37040-4746
Phone (931) 217-1833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191203001012 TN Practitioner - Clinical Psychologist 6204269467 Practice locations: Clarksville, TN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2693 Townsend CT
Suite B
Clarksville, TN 37043-6487
Phone (931) 217-1833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
246145KYMDClinical Psychologist
3642TNMDGeriatric Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Active Solutions Therapy PastSince Oct 6, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1033586748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 S RIVERSIDE DR STE D",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370404746",
            "telephone_number": "931-217-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 S RIVERSIDE DR STE D",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370404746",
            "telephone_number": "931-217-1833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DANNIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "246145",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3642",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.