Mya Harris, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

8343-123 Issued in WI

Practice address

3040 N 117TH St
Wauwatosa, WI 53222-4128

Phone

(414) 479-9990

Fax

(414) 479-0230

NPI assigned

Oct 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mya Angelou Burich Cooks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1444953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1053782003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE",
            "address_2": "MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7451",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N 117TH ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224128",
            "telephone_number": "414-479-9990",
            "fax_number": "414-479-0230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MYA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-16",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "8343-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053782003",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYA",
            "last_name": "BURICH COOKS",
            "middle_name": "ANGELOU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lyssi Harding Brady, PSYD
• Jamie W Harriman
• Harris Family Dental, SC
• Susan L Harris-Peters, APNP
• Deberah Mackenzie Harris
• Natalie Jace Harris, RD
• Laura S Harrold, PA-C
• Amber Harshaw, RN
• Katharine Elaine Davis Hart, APN, NNP-BC
• Kayla Hart, PTA

• Social Worker in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.