Active NPI
Reginald Dean Harris Jr.
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1063104784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 91351
- Practice address
- 6777 Camp Bowie Blvd Ste 229
Fort Worth, TX 76116-7157 - Phone
- (682) 703-1311
- Fax
- (817) 887-1694
- NPI assigned
- May 22, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 91351 | TX | Primary |
Addresses
Primary practice location
6777 Camp Bowie Blvd Ste 229
Fort Worth, TX 76116-7157
Mailing address
6505 Shelton Home CT
Arlington, TX 76017-0732
Phone (214) 924-8480
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 |
|---|---|---|---|
| 91351 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1063104784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6505 SHELTON HOME CT",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760170732",
"telephone_number": "214-924-8480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6777 CAMP BOWIE BLVD STE 229",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761167157",
"telephone_number": "682-703-1311",
"fax_number": "817-887-1694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "REGINALD",
"middle_name": "DEAN",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "91351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.