Individual provider Active NPI

Justin R Harker

  • Counselor
  • Rockville, MD
National Provider Identifier
1114605672
Registry record updated Jul 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
A0791 Issued in MD
Practice address
9707 Key West Ave Ste 100
Rockville, MD 20850-3992
Phone
(240) 750-6467
NPI assigned
Jul 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A0791 MD Primary

Addresses

Primary practice location

9707 Key West Ave Ste 100
Rockville, MD 20850-3992

Mailing address

1009 Schindler Dr
Silver Spring, MD 20903-1030
Phone (240) 821-0704

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260625004863 MD Practitioner - Clinical Psychologist 7517430945 Reassigns benefits to 1 organization
I20260625004906 DC Practitioner - Clinical Psychologist 7517430945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9707 Key W Ave
Suite 100
Rockville, MD 20850-3992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A0791MDMDCounselor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1114605672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 SCHINDLER DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209031030",
            "telephone_number": "240-821-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 KEY WEST AVE STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503992",
            "telephone_number": "240-750-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKER",
        "first_name": "JUSTIN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-06",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MD",
            "license": "A0791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.