Ebony Harris, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149022277 Issued in IL

Practice address

661 W Lake St Ste 2S
Chicago, IL 60661-1034

Phone

(312) 775-2045

Fax

(773) 938-8512

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1174140206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034",
            "telephone_number": "312-775-2045",
            "fax_number": "773-938-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W LAKE ST STE 2S",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611034",
            "telephone_number": "312-775-2045",
            "fax_number": "773-938-8512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Erie St Ste 525",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112980",
            "country_code": "US",
            "telephone_number": "312-818-5460",
            "fax_number": "773-938-8512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "EBONY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://spokenbalance.clientsecure.me/",
            "affiliation": "Y",
            "affiliationName": "Spoken Balance, LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 E Erie St Ste 525",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Harris
• Darrian Dewayne Harris, DNP-NA, CRNA
• Dawn Harris
• Derek Harris, LCPC
• Donna Tanisha Harris, PMHNP-BC
• Eleanor Harris, PH.D.
• Frank Darryl Harris, LCSW, CADC
• Gwendolyn Harris, CRNA
• Hailey Marie Harris, MD
• Iesha D Harris

• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.