Susanne J. Edison-Harris, LPC-MH, QMHP, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

04091200 Issued in SD

Practice address

4109 S Carnegie Cir
Sioux Falls, SD 57106-2321

Phone

(605) 331-2419

Fax

(605) 789-8026

NPI assigned

Jul 31, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susanne J. Harris Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 26, 2024 through Sep 26, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1063678811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 S CARNEGIE CIR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571062321",
            "telephone_number": "605-331-2419",
            "fax_number": "605-789-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 S CARNEGIE CIR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571062321",
            "telephone_number": "605-331-2419",
            "fax_number": "605-789-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDISON-HARRIS",
        "first_name": "SUSANNE",
        "middle_name": "J.",
        "credential": "LPC-MH, QMHP, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SD",
            "license": "LPC1115",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "04091200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNE",
            "last_name": "HARRIS",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Addiction (Substance Use Disorder) Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.