Individual provider Active NPI

Angelina Harris, LCSW, MA

  • Clinical Social Worker
  • Leesburg, VA
National Provider Identifier
1265762686
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904010517 Issued in VA
Practice address
102 Heritage Way NE Ste 302
Leesburg, VA 20176
Phone
(037) 771-5100
NPI assigned
Jan 7, 2010
Last updated
Jun 12, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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 0904010517 VA Primary

Addresses

Primary practice location

102 Heritage Way NE Ste 302
Leesburg, VA 20176

Mailing address

102 Heritage Way NE Ste 302
Leesburg, VA 20176-4544

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
0904010517VAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1265762686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201764544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 HERITAGE WAY NE STE 302",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "20176",
            "telephone_number": "037-771-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANGELINA",
        "credential": "LCSW, MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904010517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.