Active NPI
Cathy Sue Harris, LCSW
- Clinical Social Worker
- San Diego, CA
National Provider Identifier
1265519029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCS28318
- Practice address
- 3679 Voltaire St Ste B
San Diego, CA 92106-1252 - Phone
- (619) 807-9159
- Fax
- (619) 324-4192
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCS28318 | CA | Primary |
Addresses
Primary practice location
3679 Voltaire St Ste B
San Diego, CA 92106-1252
Mailing address
5050 Niagara Ave Apt 106
San Diego, CA 92107-3027
Phone (619) 807-9159
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36996 | Other | IA | BCBS/WELLMARK OF IOWA |
| 11990912 | Other | CA | CAQH |
| 1459909 | Medicaid | IA | |
| 244574 | Other | IA | MIDLANDS CHOICE |
| 737362000 | Other | IA | MAGELLAN/TITLE 19 |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts, Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCS28318 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444089600000",
"number": "1265519029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 NIAGARA AVE APT 106",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921073027",
"telephone_number": "619-807-9159",
"fax_number": "619-324-4192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3679 VOLTAIRE ST STE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921061252",
"telephone_number": "619-807-9159",
"fax_number": "619-324-4192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CATHY",
"middle_name": "SUE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2015-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "LCS28318",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS/WELLMARK OF IOWA",
"identifier": "36996",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11990912",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1459909",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLANDS CHOICE",
"identifier": "244574",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN/TITLE 19",
"identifier": "737362000",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.