Individual provider Active NPI

Jeffrey Harlow, PHD

  • Clinical Psychologist
  • Charleston, WV
National Provider Identifier
1154409480
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
344 Issued in WV
Practice address
1418 A Maccorkle Ave SW
Charleston, WV 25303
Phone
(304) 348-1288
Fax
(304) 348-1262
NPI assigned
Nov 2, 2006
Last updated
Mar 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 344 WV Primary

Addresses

Primary practice location

1418 A Maccorkle Ave SW
Charleston, WV 25303

Mailing address

PO Box 4009
Charleston, WV 25364-4009
Phone (304) 348-1288

Other identifiers 1

IdentifierTypeStateIssuer
0164868000MedicaidWV

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)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1154409480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4009",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253644009",
            "telephone_number": "304-348-1288",
            "fax_number": "304-348-1262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 A MACCORKLE AVE SW",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25303",
            "telephone_number": "304-348-1288",
            "fax_number": "304-348-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLOW",
        "first_name": "JEFFREY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164868000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.