Individual provider Active NPI

Nikki Harrell, LCSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1407250293
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73 081716 Issued in NY
Practice address
520 Cedar St
Syracuse, NY 13210-2302
Phone
(315) 435-7721
Fax
(315) 435-7715
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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 73 081716 NY Primary

Addresses

Primary practice location

520 Cedar St
Syracuse, NY 13210-2302

Mailing address

520 Cedar St
Syracuse, NY 13210-2302
Phone (315) 435-7721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220930002581 NY Practitioner - Clinical Social Worker 0446636229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
73 081716NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A & N Licensed Clinical Social Workers, PLLC Clinical CurrentSince Dec 5, 2021 Accepting new patients
Mobile Counseling of New York LCSW, PLLC Clinical CurrentSince Aug 24, 2022 Accepting new patients
Onondaga County Department of Mental Health Past Accepting new patients

Organizations & group practices 3

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": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1407250293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 CEDAR ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102302",
            "telephone_number": "315-435-7721",
            "fax_number": "315-435-7715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 CEDAR ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102302",
            "telephone_number": "315-435-7721",
            "fax_number": "315-435-7715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "NIKKI",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73 081716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.