Individual provider Active NPI

Gene David Harris, PHD

  • Clinical Psychologist
  • East Lansing, MI
National Provider Identifier
1639220627
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301007654 Issued in MI
Practice address
2001 Abbot Rd
East Lansing, MI 48823-1400
Phone
(517) 337-6545
Fax
(517) 337-3010
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301007654 MI Primary

Addresses

Primary practice location

2001 Abbot Rd
East Lansing, MI 48823-1400

Mailing address

2001 Abbot Rd
East Lansing, MI 48823-1400
Phone (517) 337-6545

Other names 1

  • Mr. David Harris Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120522001283 MI Practitioner - Clinical Psychologist 9537322920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lansing Psychological Associates IncGroup PAC ID 8426048323, 4 clinicians

Practice addresses (Care Compare)

612 W Lake Lansing Rd
Suite 400
East Lansing, MI 48823-8528
Phone (517) 337-6545

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301007654MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lansing Psychological Associates Inc CurrentSince Oct 2, 2002 Accepting new patients
Lansing Psychological Associates Inc Current Accepting new patients

Locations

2001 Abbott Rd
East Lansing, MI 48823
Phone (517) 337-6545

612 W Lake Lansing Rd
Ste 400
East Lansing, MI 48823
Phone (517) 336-4500

234 Michigan Ave
East Lansing, MI 48823
Phone (517) 337-6545

Organizations & group practices 2

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": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1639220627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 ABBOT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231400",
            "telephone_number": "517-337-6545",
            "fax_number": "517-337-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ABBOT RD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488231400",
            "telephone_number": "517-337-6545",
            "fax_number": "517-337-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GENE",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301007654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "HARRIS",
            "prefix": "MR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.