Individual provider Active NPI

Cornelius J Harris

  • Marriage & Family Therapist
  • Hartford, CT
National Provider Identifier
1710528393
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
3040 Issued in CT
Practice address
76 New Britain Ave
Hartford, CT 06106-3305
Phone
(860) 224-3642
NPI assigned
Oct 4, 2019
Last updated
Mar 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 3040 CT Primary

Addresses

Primary practice location

76 New Britain Ave
Hartford, CT 06106-3305

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1587
Phone (860) 697-3351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241210003053 CT Practitioner - Marriage and Family Therapist 4284160573 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3040CTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center Inc CurrentSince Dec 5, 2024 Accepting new patients
Grow Healthcare Group PA Marriage & Family Therapist CurrentSince Dec 24, 2024 Accepting new patients
Community Health Center Inc Marriage & Family Therapist CurrentSince Dec 5, 2024 Accepting new patients

Locations

100 Pearl St
Fl 14
Hartford, CT 06103
Phone (860) 421-6636

76 New Britain Ave
Hartford, CT 06106
Phone (860) 545-9300

19 Grand St
Middletown, CT 06457
Phone (860) 323-0172

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Interoperability endpoints

  • Direct secure messaging: cornelius.harris@chcict.eclinicaldirectplus.com

Organizations & group practices 3

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": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1710528393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951587",
            "telephone_number": "860-697-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NEW BRITAIN AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063305",
            "telephone_number": "860-224-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CORNELIUS",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-04",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "3040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.