Active NPI
Kiandra Harry, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1619444346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 90388
- Practice address
- 4364 Western Center Blvd
Fort Worth, TX 76137-2043 - Phone
- (706) 474-3424
- NPI assigned
- Oct 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Professional Counselor | 101YP2500X | 90388 | TX | Primary |
Addresses
Primary practice location
4364 Western Center Blvd
Fort Worth, TX 76137-2043
Mailing address
4364 Western Center Blvd
Pob 2047
Fort Worth, TX 76137
Phone (706) 474-3424
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
| License | State | Type | Specialty |
|---|---|---|---|
| 90388 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1619444346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4364 WESTERN CENTER BLVD",
"address_2": "POB 2047",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76137",
"telephone_number": "706-474-3424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4364 WESTERN CENTER BLVD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761372043",
"telephone_number": "706-474-3424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRY",
"first_name": "KIANDRA",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-31",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "90388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.