Active NPI
Terah Nicole Harrison, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1780993196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 64643
- Practice address
- 5751 Kroger Dr
Suite 269
Fort Worth, TX 76244-5632 - Phone
- (817) 812-2880
- NPI assigned
- Oct 3, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 64643 | TX | Primary |
| Counselor | 101Y00000X | 64643 | TX |
Addresses
Primary practice location
5751 Kroger Dr
Suite 269
Fort Worth, TX 76244-5632
Mailing address
3505 Cattlebaron Dr
Roanoke, TX 76262-5881
Phone (817) 975-0062
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 283868201 | Medicaid | TX | |
| 8588LL | Other | TX | BLUE CROSS BLUE SHIELD |
Other names 1
- Miss Terah Nicole Bowling
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 |
|---|---|---|---|
| 64643 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Logos Services, LLC | 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 and National Provider Directory roles.
-
- Mental Health Counselor
- Fort Worth, TX
- NPI 1215292081
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328054400000",
"number": "1780993196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3505 CATTLEBARON DR",
"city": "ROANOKE",
"state": "TX",
"postal_code": "762625881",
"telephone_number": "817-975-0062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5751 KROGER DR",
"address_2": "SUITE 269",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762445632",
"telephone_number": "817-812-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "TERAH",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-03",
"last_updated": "2012-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "64643",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "64643",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "283868201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8588LL",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TERAH",
"last_name": "BOWLING",
"middle_name": "NICOLE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.