Active NPI
Kerrie Rena Harris, MA, LPC
- Professional Counselor
National Provider Identifier
1669087680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2093
- Practice address
- 16 Leon Sullivan Way Suite 300
Charleston, WV 25301
UM - Phone
- (304) 654-7994
- NPI assigned
- Sep 15, 2020
- Last updated
- Sep 15, 2020
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2093 | WV | Primary |
Addresses
Primary practice location
16 Leon Sullivan Way Suite 300
Charleston, WV 25301
UM
Mailing address
100 Stone St
Culloden, WV 25510-9003
Phone (304) 654-7994
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 |
|---|---|---|---|
| 2093 | WV | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kanawha Pastoral Counseling Center | Professional | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600128000000",
"number": "1669087680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 STONE ST",
"city": "CULLODEN",
"state": "WV",
"postal_code": "255109003",
"telephone_number": "304-654-7994"
},
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "LOCATION",
"address_type": "FGN",
"address_1": "16 LEON SULLIVAN WAY SUITE 300",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25301",
"telephone_number": "304-654-7994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KERRIE",
"middle_name": "RENA",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-15",
"last_updated": "2020-09-15",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WV",
"license": "2093",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.