Summyr Nickole Harris

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC-16097 Issued in CA

Practice address

50 Dearwell Way
San Jose, CA 95138-1608

Phone

(209) 829-8039

NPI assigned

Nov 9, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Meridian Counseling

  • Marriage & Family Therapist
  • Los Angeles, CA
  • NPI 1396202206
  Medicare reassignment NPD
• Abundant Life Professional Clinical Counselor Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Carmichael, CA
  • NPI 1164225892
  NPD Authorized official

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

{
    "created_epoch": "1383955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1194154146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 SUTTERVILLE RD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958201093",
            "telephone_number": "916-452-3981",
            "fax_number": "916-226-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DEARWELL WAY",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381608",
            "telephone_number": "209-829-8039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SUMMYR",
        "middle_name": "NICKOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-09",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "7187",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC7187",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC-16097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Harris
• John Harris
• Kevin Lee Harris, DO
• Shelly Alyse Harris, LMFT, 119363
• Stephen Jacob Harris, MD
• Susan Harris, MD
• William Eugene Harris
• Harrison Limited Liability Co.
• Andrew Robert Harrison, DPM
• Bridget Maureen Harrison, M.D., M.P.H.

• Professional Counselor in San Jose, CA
• Providers in San Jose, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.