Active NPI
Marly Harris
- Professional Counselor
- Meridian, ID
National Provider Identifier
1710679709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-7745
- Practice address
- 403 W Cherry LN
Meridian, ID 83642-1610 - Phone
- (208) 546-9582
- NPI assigned
- May 25, 2023
- 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 | LPC-7745 | ID | Primary |
Addresses
Primary practice location
403 W Cherry LN
Meridian, ID 83642-1610
Mailing address
415 N Sherwood Dr
Nampa, ID 83651-1865
Phone (208) 409-1846
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-7745 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687392000000",
"number": "1710679709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 N SHERWOOD DR",
"city": "NAMPA",
"state": "ID",
"postal_code": "836511865",
"telephone_number": "208-409-1846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 W CHERRY LN",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836421610",
"telephone_number": "208-546-9582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MARLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-25",
"last_updated": "2023-06-22",
"certification_date": "2023-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-7745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.