Individual provider Active NPI

Joseph Robert Harris Jr., PH.D.

  • School Psychologist
  • Laurens, SC
National Provider Identifier
1639413420
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
311 Issued in SC
Practice address
100 Hillcrest SQ Ste J
Laurens, SC 29360-2355
Phone
(864) 984-2518
Fax
(864) 984-6037
NPI assigned
Nov 16, 2012
Last updated
Nov 16, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 311 SC Primary

Addresses

Primary practice location

100 Hillcrest SQ Ste J
Laurens, SC 29360-2355

Mailing address

100 Hillcrest SQ Ste J
P. O. Box 686
Laurens, SC 29360-2355
Phone (864) 984-2518

Other identifiers 1

IdentifierTypeStateIssuer
WP9984MedicaidSC

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
311SCMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1639413420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HILLCREST SQ STE J",
            "address_2": "P. O. BOX 686",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602355",
            "telephone_number": "864-984-2518",
            "fax_number": "864-984-6037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HILLCREST SQ STE J",
            "city": "LAURENS",
            "state": "SC",
            "postal_code": "293602355",
            "telephone_number": "864-984-2518",
            "fax_number": "864-984-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOSEPH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "SC",
            "license": "311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WP9984",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurens, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.

Verify at the official NPI Registry.