Active NPI
Peonita Harris, M.A., LMFT
- Marriage & Family Therapist
- Evanston, IL
National Provider Identifier
1447564612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 166.000838
- Practice address
- 1740 Ridge Ave
LL21
Evanston, IL 60201-5918 - Phone
- (847) 828-8196
- NPI assigned
- Jul 30, 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 166.000838 | IL | Primary |
Addresses
Primary practice location
1740 Ridge Ave
LL21
Evanston, IL 60201-5918
Mailing address
1740 Ridge Ave
Evanston, IL 60201-5918
Phone (847) 828-8196
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166.000838 | IL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314057600000",
"number": "1447564612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015918",
"telephone_number": "847-828-8196"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 RIDGE AVE",
"address_2": "LL21",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602015918",
"telephone_number": "847-828-8196"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "PEONITA",
"name_prefix": "Mrs.",
"credential": "M.A., LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-30",
"last_updated": "2011-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "IL",
"license": "166.000838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.