Jessica Ann Harrison, LCSW-C
Individual provider Active NPI Clinical Social Worker · Halethorpe, MD
NPI 1124622014 · NPPES record last updated Jul 13, 2023
Key facts
- NPI
- 1124622014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 21961 (MD)
- Practice address
- 2700 Washington Ave
Halethorpe, MD 21227-3115 - Phone
- (667) 600-3984
- Fax
- (667) 600-4065
- NPI assigned
- Nov 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Associated Catholic Charities Inc
Practice addresses (Care Compare)
2700 Washington Ave
Villa Maria Behavioral Health Clinic at Lan
Halethorpe, MD 21227-3115
Phone (667) 600-3984
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230728002707 | MD | Practitioner - Clinical Social Worker | 2163883752 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21961 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associated Catholic Charities, Inc. | Current |
Accepting new patients |
Locations
2700 Washington Ave
Lansdowne, MD 21227
Phone (667) 600-3984
2300 Dulaney Valley Rd
Ste B
Timonium, MD 21093
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21961 | MD | Yes |
Addresses
Primary practice location
2700 Washington Ave
Halethorpe, MD 21227-3115
Mailing address
5062 Judicial Way
Frederick, MD 21703-4807
Phone (908) 227-8864
Other providers in Halethorpe, MD
- Groundwork Behavioral Health Services Corp
- Groundwork Behavioral Health Services Corp
- Antoinette Gupta
- Abigail Hamilton
- Eugenia Harris
- Helen Kumolalo
- Helenas Place, LLC
- David A Hexter
- Edna Ruth Hill
- Nazaree Hines-Starr
All providers in Halethorpe, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.