Individual provider Active NPI

Tywania Laniece Harris, MSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1235884891
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P016805 Issued in NC
Practice address
1310 Raeford Rd Ste 2
Fayetteville, NC 28305-5086
Phone
(910) 485-6336
Fax
(888) 972-8390
NPI assigned
Feb 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P016805 NC Primary

Addresses

Primary practice location

1310 Raeford Rd Ste 2
Fayetteville, NC 28305-5086

Mailing address

46 Michelle CT
Lillington, NC 27546-0016
Phone (313) 409-6253

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL URL Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P016805NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Verna Dority, MSW, CCSW, Inc Clinical CurrentSince Feb 24, 2022 Accepting new patients

Locations

1310 Raeford Rd
Ste 2
Fayetteville, NC 28305
Phone (910) 850-0367

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1644624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644624000000",
    "number": "1235884891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 MICHELLE CT",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275460016",
            "telephone_number": "313-409-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 RAEFORD RD STE 2",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055086",
            "telephone_number": "910-485-6336",
            "fax_number": "888-972-8390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TYWANIA",
        "middle_name": "LANIECE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-12",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P016805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "URL",
            "affiliation": "N",
            "endpointDescription": "URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1310 Raeford Rd Ste 2",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283055086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.