Johnathon Grant Harris, MS, LPCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CC04354 Issued in MN

Practice address

510 Sibley St
Mankato, MN 56001-2056

Phone

(507) 484-2400

Fax

(507) 934-5220

NPI assigned

Apr 9, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Leo a Hoffmann Center IncGroup PAC ID 6709117500, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Master of Science - Law

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.

• Leo a. Hoffmann Center, Inc.

  • Psychologist
  • Saint Peter, MN
  • NPI 1407376072
  Medicare reassignment Care Compare group NPD
• Leo a. Hoffmann Center, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • St. Peter, MN
  • NPI 1093876732
  NPD (past)

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

{
    "created_epoch": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1245083393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 SIBLEY ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012056",
            "telephone_number": "507-484-2400",
            "fax_number": "507-934-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 SIBLEY ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560012056",
            "telephone_number": "507-484-2400",
            "fax_number": "507-934-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHNATHON",
        "middle_name": "GRANT",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "CC04354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Harding, M.S.
• Glenn Harman, MD
• Edwin Dexter Harrington, M.D.
• Albert R Harris, M.D.
• Jennie Harris
• Kayla Harris
• Harry Meyering Center, Inc.
• Harry Meyering Centr, Inc.
• Alexis Harstad
• Sharla Hart, M.A,V.C.

• Mental Health Counselor in Mankato, MN
• Providers in Mankato, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.