Active NPI
Robert William Harelson, PSYD
- Marriage & Family Therapist
- Lafayette, CA
National Provider Identifier
1508924010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC4176
- Practice address
- 3411 Mt Diablo Blvd
C
Lafayette, CA 94549-3914 - Phone
- (925) 639-2555
- NPI assigned
- Dec 5, 2006
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC4176 | CA | Primary |
Addresses
Primary practice location
3411 Mt Diablo Blvd
C
Lafayette, CA 94549-3914
Mailing address
6624 Las Animas Dr
Martinez, CA 94553-6109
Phone (925) 639-2555
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4176 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| MFC4176 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326499200000",
"number": "1508924010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6624 LAS ANIMAS DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945536109",
"telephone_number": "925-639-2555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3411 MT DIABLO BLVD",
"address_2": "C",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493914",
"telephone_number": "925-639-2555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARELSON",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-05",
"last_updated": "2012-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC4176",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.