Individual provider Active NPI

Nichole B Harrison, M.D.

  • Psychiatry Physician
  • Bradford, PA
National Provider Identifier
1609888643
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD434692 Issued in PA
Practice address
110 Campus Dr
Bradford, PA 16701-1982
Phone
(814) 362-6535
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 237551-1 NY
Psychiatry Physician 2084P0800X MD434692 PA Primary
Internal Medicine Physician 207R00000X MD434692 PA

Addresses

Primary practice location

110 Campus Dr
Bradford, PA 16701-1982

Mailing address

110 Campus Dr
Bradford, PA 16701-1982
Phone (814) 362-6536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090316000372 PA Practitioner - PsychiatryPractitioner - Internal Medicine 3577620723 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
237551-1NYMDLicensed Practical Nurse
MD434692PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Guidance Center CurrentSince Sep 11, 2025 Accepting new patients
Pennsylvania Department of Human Services CurrentSince Dec 11, 2013 Accepting new patients
Pennsylvania Department of Public Welfare CurrentSince Dec 11, 2013 Accepting new patients

Locations

110 Campus Dr
Bradford, PA 16701
Phone (814) 362-6535

33 Main Dr
Warren, PA 16365
Phone (814) 723-5500

Organizations & group practices 4

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1609888643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6536",
            "fax_number": "814-817-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DR",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167011982",
            "telephone_number": "814-362-6535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "NICHOLE",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "237551-1",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "PA",
            "license": "MD434692",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD434692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, PA

Sources for this page

Verify at the official NPI Registry.