Active NPI
Herbert Harris Sr.
- Mental Health Counselor
- Detroit, MI
National Provider Identifier
1366859795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6802064962
- Practice address
- 17563 Kentucky St
Detroit, MI 48221-2408 - Phone
- (313) 927-2779
- Fax
- (313) 826-0565
- NPI assigned
- Jul 17, 2014
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6802064962 | MI | Primary |
Addresses
Primary practice location
17563 Kentucky St
Detroit, MI 48221-2408
Mailing address
17563 Kentucky St
Detroit, MI 48221-2408
Phone (313) 733-4859
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802064962 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1366859795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17563 KENTUCKY ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482212408",
"telephone_number": "313-733-4859",
"fax_number": "313-826-0565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17563 KENTUCKY ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482212408",
"telephone_number": "313-927-2779",
"fax_number": "313-826-0565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "HERBERT",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-17",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "6802064962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.