Individual provider Active NPI

Teresa Ann Harris, LMHC PSY.D.

  • Mental Health Counselor
  • Lakeland, FL
National Provider Identifier
1477769693
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5429 Issued in FL
Practice address
130 S Massachusetts Ave Ste 803
Lakeland, FL 33801-5031
Phone
(727) 200-2310
Fax
(727) 499-5311
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5429 FL
Mental Health Counselor 101YM0800X 5429 FL Primary

Addresses

Primary practice location

130 S Massachusetts Ave Ste 803
Lakeland, FL 33801-5031

Mailing address

130 S Massachusetts Ave FL 33801
Lakeland, FL 33801-5003
Phone (727) 200-2310

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

LicenseStateTypeSpecialty
5429FLMDMental Health Counselor
MH5429FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teresaharris@tdh.allscriptsdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1477769693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S MASSACHUSETTS AVE FL 33801",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015003",
            "telephone_number": "727-200-2310",
            "fax_number": "727-499-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S MASSACHUSETTS AVE STE 803",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015031",
            "telephone_number": "727-200-2310",
            "fax_number": "727-499-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "LMHC PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5429",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "5429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.