Individual provider Active NPI

Elisa M Harris, PH.D.

  • Counseling Psychologist
  • Johnson City, NY
National Provider Identifier
1265012934
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
024333 Issued in NY
Practice address
167 Oakdale Rd
Johnson City, NY 13790-1007
Phone
(607) 600-9687
Fax
(607) 306-2063
NPI assigned
Apr 8, 2021
Last updated
Jul 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X NY
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 024333 NY Primary

Addresses

Primary practice location

167 Oakdale Rd
Johnson City, NY 13790-1007

Mailing address

167 Oakdale Rd
Johnson City, NY 13790-1007
Phone (607) 600-9687

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
024333NYMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Journey Through Psychological Services LLC Counseling CurrentSince Jul 7, 2024 Accepting new patients

Locations

167 Oakdale Rd
Johnson City, NY 13790
Phone (607) 427-4430

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1265012934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-600-9687",
            "fax_number": "607-306-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 OAKDALE RD",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137901007",
            "telephone_number": "607-600-9687",
            "fax_number": "607-306-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELISA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2024-07-02",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "024333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.