Maxie Harris, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 7769 Issued in FL

Practice address

1848 SE 1St Ave Ste 4
Fort Lauderdale, FL 33316

Phone

(954) 885-9500

Fax

(954) 885-9444

NPI assigned

Aug 4, 2008

Sex

Male

Sole proprietor

Yes

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 FL

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

Clinical Psychologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Boca Raton Psychology Group PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boca Raton,, FL
  • NPI 1104670256
  Medicare reassignment NPD Authorized official
• Pro Performance Physical Therapy LLC

  • Physical Therapist
  • Fort Lauderdale, FL
  • NPI 1215598529
  NPD (past)

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1346406840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE STE 4",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162875",
            "telephone_number": "954-885-9500",
            "fax_number": "954-885-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 SE 1ST AVE STE 4",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-885-9500",
            "fax_number": "954-885-9444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3349 N University Dr",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330249000",
            "country_code": "US",
            "telephone_number": "954-885-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MAXIE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Fred Harrelson, L.M.T.
• Cheryl M Harrington, LCSW
• Tamica Harris-Cuffy, LMHC
• Kimberly A Harris, ARNP
• Lashavious A Harris, RBT
• Paulamae Harris
• Sarah Kenly Harris
• Craig Harrison, M.D., MPH
• Delphine Harrison
• Matthew Harrison, DPT

• Clinical Psychologist in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.