Micheline Mutombo-Harris

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

27267 Issued in MN

Practice address

525 Portland Ave # Mc963
Minneapolis, MN 55415-1533

Phone

(612) 596-1223

NPI assigned

Oct 9, 2019

Last updated

Feb 27, 2025By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• The Mental Health Collective

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Minneapolis, MN
  • NPI 1932126794
  NPD (past)
• Watercourse Counseling Center

  • Community/Behavioral Health Agency
  • Minneapolis, MN
  • NPI 1770847246
  NPD (past)

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

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1336781541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PORTLAND AVE # MC963",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554151533",
            "telephone_number": "612-596-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTOMBO-HARRIS",
        "first_name": "MICHELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-09",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tandiwe Musukwa
• John Andrew Muthama, MD
• Sarah Muthoni
• Brian Kirti Muthyala, MD
• Mutnick Allergy & Asthma, L.L.C.
• Melinda Mutschler, PA
• Mounika Muttineni, DO
• Jill Mutziger Johnson, PHARMD
• Bilqis Siddiqah Muzaffarr, APRN, CNP
• MV's Care, Wellness and Human Service L.L.C (MV's Care and Wellness)

• Clinical Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.