Active NPI
Jane Harris, MA LP
- Counseling Psychologist
- Plymouth, MN
National Provider Identifier
1629005277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP3146
- Practice address
- 3131 Fernbrook LN N
Suite 102
Plymouth, MN 55447-5321 - Phone
- (612) 839-7975
- NPI assigned
- Jun 27, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP3146 | MN | Primary |
Addresses
Primary practice location
3131 Fernbrook LN N
Suite 102
Plymouth, MN 55447-5321
Mailing address
15840 Elodie LN
Minnetonka, MN 55345-4545
Phone (612) 839-7975
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 664817700 | Medicaid | MN |
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 |
|---|---|---|---|
| LP3146 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1629005277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15840 ELODIE LN",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553454545",
"telephone_number": "612-839-7975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 FERNBROOK LN N",
"address_2": "SUITE 102",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554475321",
"telephone_number": "612-839-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "JANE",
"name_prefix": "Mrs.",
"credential": "MA LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-27",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP3146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "664817700",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.