Individual provider Active NPI

Kim Kelly Harriman, MSW, LICSW

  • Clinical Social Worker
  • Hanover, MA
National Provider Identifier
1003903097
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
106411 Issued in MA
Practice address
135 Webster St
Hanover, MA 02339-1200
Phone
(781) 982-9790
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 106411 MA Primary

Addresses

Primary practice location

135 Webster St
Hanover, MA 02339-1200

Mailing address

25 Linden Ave
Scituate, MA 02066-3905
Phone (781) 545-9884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051011001170 MA Practitioner - Clinical Social Worker 7214952977 Practice locations: Hingham, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

185 Lincoln St
Suite 210
Hingham, MA 02043-1743
Phone (781) 910-4445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003903097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 LINDEN AVE",
            "city": "SCITUATE",
            "state": "MA",
            "postal_code": "020663905",
            "telephone_number": "781-545-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 WEBSTER ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023391200",
            "telephone_number": "781-982-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIMAN",
        "first_name": "KIM",
        "middle_name": "KELLY",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "106411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MA

Sources for this page

Verify at the official NPI Registry.