Kanisha Harrison

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11303 Issued in SC

Practice address

2680 Gradys Ground Dr N
MC Connells, SC 29726-6776

Phone

(803) 272-9645

NPI assigned

Sep 14, 2020

Last updated

Sep 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kanisha.harrison@therapist.net

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1073128211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2680 GRADYS GROUND DR N",
            "city": "MC CONNELLS",
            "state": "SC",
            "postal_code": "297266776",
            "telephone_number": "803-272-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 GRADYS GROUND DR N",
            "city": "MC CONNELLS",
            "state": "SC",
            "postal_code": "297266776",
            "telephone_number": "803-272-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "KANISHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CO12524",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "11303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kanisha.Harrison@therapist.net",
            "affiliation": "N",
            "address_1": "2680 Gradys Ground Dr N",
            "city": "Mc Connells",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297266776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Judy Diane Hayes, CRNA
• Lacey Kelly
• Katherine Williams

• Clinical Social Worker in McConnells, SC
• Providers in McConnells, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.