Individual provider Active NPI

Sarina Renee Harris

  • Social Worker
  • Flint, MI
National Provider Identifier
1053920801
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801108584 Issued in MI
Practice address
2387 S Linden Rd Ste 137
Flint, MI 48532-5488
Phone
(989) 475-4171
Fax
(989) 393-6021
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801096493 MI
Social Worker 104100000X 6801108584 MI Primary

Addresses

Primary practice location

2387 S Linden Rd Ste 137
Flint, MI 48532-5488

Mailing address

2387 S Linden Rd Ste 137
Flint, MI 48532-5488
Phone (989) 475-4171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210308001682 MI Practitioner - Clinical Social Worker 8325454895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

6548 Town Ctr Dr
Suite D
Clarkston, MI 48346-4823
Phone (800) 693-1916

89 W S Blvd
200 Great Lakes Psychology Group
Troy, MI 48085-1612
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801108584MIMDSocial Worker
6801096493MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Jan 17, 2021 Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

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.

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1053920801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2387 S LINDEN RD STE 137",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325488",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2387 S LINDEN RD STE 137",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485325488",
            "telephone_number": "989-475-4171",
            "fax_number": "989-393-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SARINA",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096493",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801108584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.