Beverly Dawn Harris, MSW, PLCSW
Individual provider Active NPI Clinical Social Worker · Republic, MO
NPI 1295896405 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1295896405
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2006022591 (MO)
- Practice address
- 2715 E Logan St
Republic, MO 65738-2293 - Phone
- (417) 459-2969
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2006
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1230 N Duquesne Rd
Joplin, MO 64801-1509
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100504000824 | MO | Practitioner - Clinical Social Worker | 2062540503 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Tri-County Health Care Consortium | Current | Accepting new patients | |
| Ozark Tri-County Health Care Consortium | Current |
Accepting new patients | |
| Ozark Tri-County Health Care Consortium | Current |
Accepting new patients | |
| Touchstone Counseling LLC | Past | Accepting new patients |
Locations
927 N Highway 71
Anderson, MO 64831
Phone (417) 845-2273
530 S Maiden Ln
Joplin, MO 64801
Phone (417) 223-4385
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2006022591 | MO | Yes |
Addresses
Primary practice location
2715 E Logan St
Republic, MO 65738-2293
Mailing address
2715 E Logan St
Republic, MO 65738-2293
Phone (417) 459-2969
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 491031100 | Medicaid | MO |
Other providers in Republic, MO
- Grateful Heart Counseling LLC
- Latisha Hall
- Erin Hanson
- Zach David Hanson
- Levi Keith Hare-Townsend
- Justin Lee Hart
- Linse L Hawks
- Healthy Roots Counseling, LLC
- David J Heitman
- Kathryn A. Herfkens-Ampleman
All providers in Republic, MO · Clinical Social Worker in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.