Individual provider Active NPI

Colette Dion Harley, BA

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1174655799
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
79089 Issued in CA
Practice address
11601 S Western Ave
Los Angeles, CA 90047-5006
Phone
(323) 242-5000
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 79089 CA Primary

Addresses

Primary practice location

11601 S Western Ave
Los Angeles, CA 90047-5006

Mailing address

11601 S Western Ave
Los Angeles, CA 90047-5006
Phone (323) 242-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240521003954 CA Practitioner - Marriage and Family Therapist 2769824812 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
79089CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Los Angeles County Department of Public Health Current Accepting new patients
Clear View Behavioral Services Marriage & Family Therapist CurrentSince May 9, 2024 Accepting new patients

Locations

1902 Orange Tree Ln
Ste 200
Redlands, CA 92374
Phone (909) 798-6200

Interoperability endpoints

  • Direct secure messaging: colettejames-shieldsforfamilies@lacsapc.netsmartdirect.net

Organizations & group practices 2

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1174655799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475006",
            "telephone_number": "323-242-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 S WESTERN AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900475006",
            "telephone_number": "323-242-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLEY",
        "first_name": "COLETTE",
        "middle_name": "DION",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "79089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.