Active NPI
Larry Bernard Harris II
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1629484431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 7647 Boulder LN
Apt. J13
Indianapolis, IN 46260-3043 - Phone
- (317) 500-7991
- NPI assigned
- Jul 1, 2014
- Last updated
- Jul 1, 2014
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IN | Primary |
Addresses
Primary practice location
7647 Boulder LN
Apt. J13
Indianapolis, IN 46260-3043
Mailing address
7647 Boulder LN
Apt. J13
Indianapolis, IN 46260-3043
Phone (317) 500-7991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201057300 A | Other | IN | MEDICAID LEGACY PROVIDER ID |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404172800000",
"number": "1629484431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7647 BOULDER LN",
"address_2": "APT. J13",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462603043",
"telephone_number": "317-500-7991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7647 BOULDER LN",
"address_2": "APT. J13",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462603043",
"telephone_number": "317-500-7991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "LARRY",
"middle_name": "BERNARD",
"name_suffix": "II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-01",
"last_updated": "2014-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LEGACY PROVIDER ID",
"identifier": "201057300 A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.