Active NPI
Roshun J Harris, MA, LCPC
- Professional Counselor
- Windsor Mill, MD
National Provider Identifier
1366768608
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Sep 20, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC3404
- Practice address
- 2505 Lord Baltimore Dr
Suite A102
Windsor Mill, MD 21244-2673 - Phone
- (410) 903-3178
- Fax
- (866) 623-6129
- NPI assigned
- Apr 12, 2010
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC3404 | MD | Primary |
Addresses
Primary practice location
2505 Lord Baltimore Dr
Suite A102
Windsor Mill, MD 21244-2673
Mailing address
2505 Lord Baltimore Dr
Suite A102
Windsor Mill, MD 21244-2673
Phone (410) 903-3178
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 030347000 | Medicaid | MD |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC3404 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436832000000",
"number": "1366768608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 LORD BALTIMORE DR",
"address_2": "SUITE A102",
"city": "WINDSOR MILL",
"state": "MD",
"postal_code": "212442673",
"telephone_number": "410-903-3178",
"fax_number": "866-623-6129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2505 LORD BALTIMORE DR",
"address_2": "SUITE A102",
"city": "WINDSOR MILL",
"state": "MD",
"postal_code": "212442673",
"telephone_number": "410-903-3178",
"fax_number": "866-623-6129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ROSHUN",
"middle_name": "J",
"credential": "MA, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-12",
"last_updated": "2015-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC3404",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "030347000",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Windsor Mill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.