Active NPI
Glenetta Hudson Harris, PH.D.
- Clinical Psychologist
- Gaithersburg, MD
National Provider Identifier
1346514288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 04885
- Practice address
- 847 Quince Orchard Blvd Ste E
Gaithersburg, MD 20878-1677 - Phone
- (301) 836-1426
- Fax
- (301) 263-7710
- NPI assigned
- Feb 23, 2012
- Last updated
- Oct 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 04885 | MD | Primary |
Addresses
Primary practice location
847 Quince Orchard Blvd Ste E
Gaithersburg, MD 20878-1677
Mailing address
847 Quince Orchard Blvd Ste E
Gaithersburg, MD 20878-1677
Phone (301) 836-1426
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04885 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381968000000",
"number": "1346514288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "847 QUINCE ORCHARD BLVD STE E",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208781677",
"telephone_number": "301-836-1426",
"fax_number": "301-263-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "847 QUINCE ORCHARD BLVD STE E",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208781677",
"telephone_number": "301-836-1426",
"fax_number": "301-263-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON HARRIS",
"first_name": "GLENETTA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-23",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "04885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.