Individual provider Active NPI

Alissa Renee Harris, LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1356694491
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801095158 Issued in MI
Practice address
3820 Packard St Ste 250
Ann Arbor, MI 48108-5017
Phone
(734) 780-7338
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801095158 MI Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

3820 Packard St Ste 250
Ann Arbor, MI 48108-5017

Mailing address

3820 Packard St Ste 250
Ann Arbor, MI 48108-5017
Phone (734) 780-7338

Other names 1

  • Miss Alissa Renee Bleecker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801095158MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Emdr and Trauma Therapy CurrentSince Mar 30, 2025 Accepting new patients

Locations

3820 Packard St
Ste 250
Ann Arbor, MI 48108
Phone (734) 476-5024

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1356694491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 PACKARD ST STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085017",
            "telephone_number": "734-780-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 PACKARD ST STE 250",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085017",
            "telephone_number": "734-780-7338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ALISSA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095158",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISSA",
            "last_name": "BLEECKER",
            "middle_name": "RENEE",
            "prefix": "MISS",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

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