Active NPI
Rosetta Walker Harris, LCSW
- Mental Health Counselor
- Jackson, MS
National Provider Identifier
1386682102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C1817
- Practice address
- 248 E Capitol St
840 Trust Mark BLDG.
Jackson, MS 39201-2503 - Phone
- (800) 632-6074
- Fax
- (866) 341-7509
- NPI assigned
- Jun 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C1817 | MS | Primary |
Addresses
Primary practice location
248 E Capitol St
840 Trust Mark BLDG.
Jackson, MS 39201-2503
Mailing address
110 Freedom St
PO Box 159
Itta Bena, MS 38941-2507
Phone (662) 392-2871
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C1817 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386682102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 FREEDOM ST",
"address_2": "PO BOX 159",
"city": "ITTA BENA",
"state": "MS",
"postal_code": "389412507",
"telephone_number": "662-392-2871"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "248 E CAPITOL ST",
"address_2": "840 TRUST MARK BLDG.",
"city": "JACKSON",
"state": "MS",
"postal_code": "392012503",
"telephone_number": "800-632-6074",
"fax_number": "866-341-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ROSETTA",
"middle_name": "WALKER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "C1817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.