Theresa E Harris, MSW, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2002012583 Issued in MO

Practice address

1835 S. 2ND Street
Clinton, MO 64735-9165

Phone

(660) 885-9100

Fax

(660) 885-9116

NPI assigned

May 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Theresa E Blankenship-Corl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Twin Lakes Counseling Center

  • Clinical Social Worker
  • Clinton, MO
  • NPI 1205816089
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1285684159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8085 NW 151 RD",
            "city": "LOWRY CITY",
            "state": "MO",
            "postal_code": "647639165",
            "telephone_number": "417-309-0207",
            "fax_number": "660-885-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 S. 2ND STREET",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647359165",
            "telephone_number": "660-885-9100",
            "fax_number": "660-885-9116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "THERESA",
        "middle_name": "E",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2002012583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "BLANKENSHIP-CORL",
            "middle_name": "E",
            "credential": "MSW,LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luke Adam Hagle, RPH
• Beth Ann Hakala, D.O., PH.D.
• Kamna Handa, MD
• Hanger Prosthetics & Orthotics East, Inc.
• Janet Lynn Hankins, M.D.
• Harrison Chiropractic LLC
• Michael Jay Harrison, D.C.
• Colleen Kaye Harshman
• Casey Brianna Hatfield, SLP
• Hallie Grace Henderson, SLPA

• Social Worker in Clinton, MO
• Providers in Clinton, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.