Wanda Jean Harris, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PO12311 Issued in NC

Practice address

2003 NC-54 C
Durham, NC 27713

Phone

(919) 682-5300

NPI assigned

Oct 8, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Upward Change Health Services

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1912449158
  NPD (past)
• Upward Change Health Services, LLC

  • Community/Behavioral Health Agency
  • Durham, NC
  • NPI 1306083688
  NPD (past)

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1225409808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7222 PLUMLEAF RD APT 1418",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276133894",
            "telephone_number": "401-228-5189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 NC-54 C",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27713",
            "telephone_number": "919-682-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3125 Poplarwood Ct Ste 300",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276046445",
            "country_code": "US",
            "telephone_number": "919-790-8580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WANDA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-08",
        "last_updated": "2022-07-08",
        "certification_date": "2022-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "CSW01612",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "PO12311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaquana Harris
• Sherri Harris
• Stacy Laughton Harris, PT, DPT
• Sunit Peter Harris, M.D.
• Tangee Renee Harris
• Allison Harrison, MS, RD, LDN
• Dean Harrison, M.D.
• Emily Harrison
• Jan C Harrison, M.D.
• John K. Harrison, M.D.

• All providers in Durham, NC
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.