Organization Active NPI

Melissa Harrison, LLC

  • Clinical Psychologist
  • Coral Springs, FL
National Provider Identifier
1720536717
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MELISSA HARRISON, LLC
Practice address
11555 Heron Bay Blvd
Suite 200
Coral Springs, FL 33076-3360
Phone
(954) 603-0077
NPI assigned
Sep 19, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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

Authorized official

Name
Dr. Melissa Ann Harrison, PSY.D.NPI 1932196201
Title
Owner
Phone
(954) 603-0077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

11555 Heron Bay Blvd
Suite 200
Coral Springs, FL 33076-3360

Mailing address

11555 Heron Bay Blvd
Suite 200
Coral Springs, FL 33076-3360
Phone (954) 603-0077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170524002749 FL Part B Supplier - Clinic/Group Practice 9830466739 Receives reassigned benefits from 1 practitioner
Practice locations: Coral Springs, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1720536717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11555 HERON BAY BLVD",
            "address_2": "SUITE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763360",
            "telephone_number": "954-603-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 HERON BAY BLVD",
            "address_2": "SUITE 200",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763360",
            "telephone_number": "954-603-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA HARRISON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-603-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.