Active NPI
Thomas H Harrell, PH.D.
- Cognitive & Behavioral Psychologist
- Melbourne, FL
National Provider Identifier
1407095284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- 3193
- Practice address
- 2603 Canary Isles Dr
Melbourne, FL 32901-6821 - Phone
- (321) 725-7205
- NPI assigned
- Feb 18, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 3193 | FL | Primary |
| Health Psychologist | 103TH0004X | 3193 | FL |
Addresses
Primary practice location
2603 Canary Isles Dr
Melbourne, FL 32901-6821
Mailing address
2603 Canary Isles Dr
Melbourne, FL 32901-6821
Phone (321) 725-7205
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 |
|---|---|---|---|
| 3193 | FL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234915200000",
"number": "1407095284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2603 CANARY ISLES DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329016821",
"telephone_number": "321-725-7205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2603 CANARY ISLES DR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329016821",
"telephone_number": "321-725-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "THOMAS",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-18",
"last_updated": "2009-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "FL",
"license": "3193",
"primary": true
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "FL",
"license": "3193",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.