Individual provider Active NPI

Melodie Harmon, LICSW

  • Clinical Social Worker
  • Bristol, RI
National Provider Identifier
1306383120
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117602 Issued in MA
Practice address
295 Hope St
Bristol, RI 02809-2016
Phone
(508) 868-4252
NPI assigned
Jan 31, 2017
Last updated
Oct 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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 117602 MA Primary

Addresses

Primary practice location

295 Hope St
Bristol, RI 02809-2016

Mailing address

295 Hope St
Bristol, RI 02809-2016
Phone (508) 868-4252

Other identifiers 1

IdentifierTypeStateIssuer
240385MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170213002683 AZ Practitioner - Clinical Social Worker 3375826530 Reassigns benefits to 1 organization
I20200226001986 MA Practitioner - Clinical Social Worker 3375826530 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117602MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Oct 31, 2023 Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1306383120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 HOPE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028092016",
            "telephone_number": "508-868-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 HOPE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028092016",
            "telephone_number": "508-868-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARMON",
        "first_name": "MELODIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240385",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, RI

Sources for this page

Verify at the official NPI Registry.