Denetta V Harris, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2204004 Issued in OH

Practice address

955 Congress Park Dr
Centerville, OH 45459-4009

Phone

(937) 907-1437

Fax

(937) 741-4788

NPI assigned

Apr 5, 2011

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

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• J. Kilby Enterprises, Inc.

  dba Ellie Mental Health

  • Mental Health Counselor
  • Centerville, OH
  • NPI 1316652894
  Medicare reassignment NPD

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1295024750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 CONGRESS PARK DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594009",
            "telephone_number": "937-907-1437",
            "fax_number": "937-741-4788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 CONGRESS PARK DR",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "454594009",
            "telephone_number": "937-907-1437",
            "fax_number": "937-741-4788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Cook Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "OH",
            "postal_code": "450369600",
            "country_code": "US",
            "telephone_number": "513-695-1357",
            "fax_number": "513-695-2952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DENETTA",
        "middle_name": "V",
        "credential": "MSW, LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2204004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Hansen
• Lisa Hansford, MA. LSW
• Shelley A Harmony, R.N.
• Christina Ann Harper, AU.D.
• Kirsten Harrell, PSYD
• Eric Harris, FNP
• Karen Hartman, RN
• Rebecca Lynn Hasbrook, RPH
• Cary Hatton, ED.D.
• Annette Kathryn Hawthorn

• Clinical Social Worker in Centerville, OH
• Providers in Centerville, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.