Healthcare Provider Details

I. General information

NPI: 1316047061
Provider Name (Legal Business Name): ROBERT NEIL HARRIS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNIVERSITY BLVD COMMUNITY PSYCH. SERVICE/STADLER HALL #232
SAINT LOUIS MO
63121-4400
US

IV. Provider business mailing address

1 UNIVERSITY BLVD COMMUNITY PSYCH. SERVICE/STADLER HALL #232
SAINT LOUIS MO
63121-4400
US

V. Phone/Fax

Practice location:
  • Phone: 314-516-5824
  • Fax: 314-516-5347
Mailing address:
  • Phone: 314-516-5824
  • Fax: 314-516-5347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPYR0366
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPYR0366
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPYR0366
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: