Active NPI
Paul David Harrison, LICSW
- Clinical Social Worker
- Arlington, MA
National Provider Identifier
1083029052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 119401
- Practice address
- 259 Massachusetts Ave
Arlington, MA 02474-8406 - Phone
- (978) 618-5288
- Fax
- (339) 707-2492
- NPI assigned
- Jun 27, 2014
- Last updated
- Feb 22, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 219242 | MA | |
| Clinical Social Worker | 1041C0700X | 119401 | MA | Primary |
Addresses
Primary practice location
259 Massachusetts Ave
Arlington, MA 02474-8406
Mailing address
259 Massachusetts Ave
Arlington, MA 02474-8406
Phone (978) 618-5288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219242 | MA | MD | Social Worker |
| 119401 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1083029052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 MASSACHUSETTS AVE",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024748406",
"telephone_number": "978-618-5288",
"fax_number": "339-707-2492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 MASSACHUSETTS AVE",
"city": "ARLINGTON",
"state": "MA",
"postal_code": "024748406",
"telephone_number": "978-618-5288",
"fax_number": "339-707-2492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "PAUL",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-06-27",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "219242",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "119401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.