Glen D Harris, M.A

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

6009 Financial PLZ Ste 102
Shreveport, LA 71129-2615

Phone

(318) 828-1455

NPI assigned

Oct 22, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

Practice roles

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.

• Mind Rehabilitation and Resource Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
  • NPI 1851688105
  NPD (past)
• Success Counseling Services North Dba Success Insite

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bossier City, LA
  • NPI 1699780122
  NPD (past)

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1407228075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 BARKSDALE BLVD",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "71111",
            "telephone_number": "318-222-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6009 FINANCIAL PLZ STE 102",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292615",
            "telephone_number": "318-828-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1504 Barksdale Blvd",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "71111",
            "country_code": "US",
            "telephone_number": "318-222-4299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GLEN",
        "middle_name": "D",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-22",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destiny Harris
• Diana Harris
• Donna Harris
• Elke Webb Harris, LMSW
• Gerald Holden Harris
• Hanna Harris
• Ja'Lisa Harris
• James Clay Harris, NP
• Jerilyn Patrice Harris
• Jodie G Harris, M.A., CCC-SLP

• Case Manager/Care Coordinator in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.