Active NPI
Celesta Harris, PH.D
- Forensic Psychologist
- Austin, TX
National Provider Identifier
1972902740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 36729
- Practice address
- 11010 Domain Dr
#11331
Austin, TX 78758-7711 - Phone
- (817) 707-7637
- NPI assigned
- Aug 18, 2014
- Last updated
- Aug 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | 36729 | TX | Primary |
Addresses
Primary practice location
11010 Domain Dr
#11331
Austin, TX 78758-7711
Mailing address
11010 Domain Dr
#11331
Austin, TX 78758-7711
Phone (817) 707-7637
Other names 1
- Celesta Taylor
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36729 | TX | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408320000000",
"number": "1972902740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11010 DOMAIN DR",
"address_2": "#11331",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787587711",
"telephone_number": "817-707-7637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11010 DOMAIN DR",
"address_2": "#11331",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787587711",
"telephone_number": "817-707-7637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CELESTA",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-18",
"last_updated": "2014-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "TX",
"license": "36729",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CELESTA",
"last_name": "TAYLOR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.