Individual provider Active NPI

Shir Wasserman-Harless, PSY.D.

  • Clinical Psychologist
  • Somerset, KY
National Provider Identifier
1750115952
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
000000 Issued in KY
Practice address
200 Belmont Ave
Somerset, KY 42501-2419
Phone
(606) 687-2038
NPI assigned
Aug 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exercise & Sports Psychologist 103TE1100X 0000000 KY
Clinical Psychologist 103TC0700X 000000 KY Primary

Addresses

Primary practice location

200 Belmont Ave
Somerset, KY 42501-2419

Mailing address

PO Box 3044
West Somerset, KY 42564-3044
Phone (606) 687-2038

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241114000705 KY Practitioner - Psychologist Billing Independently 3870027709 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellspring Counseling KyGroup PAC ID 9537420898, 5 clinicians

Practice addresses (Care Compare)

200 Belmont Ave
Somerset, KY 42501-2419
Phone (606) 687-2038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000000KYMDGeneral Practice Dentistry
000000KYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspring Counseling Ky Clinical CurrentSince Oct 10, 2024 Accepting new patients
Wellsprings Wellness LLC Clinical CurrentSince Oct 10, 2024 Accepting new patients

Locations

200 Belmont Ave
Somerset, KY 42501
Phone (606) 678-2038

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756944000000",
    "number": "1750115952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3044",
            "city": "WEST SOMERSET",
            "state": "KY",
            "postal_code": "425643044",
            "telephone_number": "606-687-2038",
            "fax_number": "606-200-3654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BELMONT AVE",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425012419",
            "telephone_number": "606-687-2038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN-HARLESS",
        "first_name": "SHIR",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TE1100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Exercise & Sports",
            "state": "KY",
            "license": "0000000",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KY",
            "license": "000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.