Michelle Fuller Harris, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3757 Issued in LA

Practice address

39094 N Angelle CT
Gonzales, LA 70737

Phone

(225) 931-2653

Fax

(225) 677-8666

NPI assigned

Aug 22, 2017

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 identifiers 1

Other names 1

• Michelle Leigh Fuller Former name

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Specialized Social Work Solutions

  • Clinical Social Worker
  • Gonzales, LA
  • NPI 1245849322
  NPD Authorized official

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1215453121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96",
            "city": "DUPLESSIS",
            "state": "LA",
            "postal_code": "707280096",
            "telephone_number": "225-931-2653",
            "fax_number": "225-677-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39094 N ANGELLE CT",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "70737",
            "telephone_number": "225-931-2653",
            "fax_number": "225-677-8666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39094 N Angelle Ct",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "70737",
            "country_code": "US",
            "telephone_number": "225-931-2653",
            "fax_number": "225-677-8666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MICHELLE",
        "middle_name": "FULLER",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "LA",
            "license": "AN550373",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "3757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2486632",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "FULLER",
            "middle_name": "LEIGH",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Breshea Harris, HIS
• Carmesha Danielle Harris, SPECIALIST
• Heaven Harris, OD
• Jenna V Harris, MS, CF-SLP
• Joseph Steven Harris, BSPHARM
• Laurice Derozan Harrison, DR.
• Sydnie Harrison
• Heidi Hartdegen, LCSW
• Harvey Pharmaceuticals 2 LLC (Healthy Stats)
• Harvey Pharmaceuticals, LLC

• Clinical Social Worker in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Clinical Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.