Angela Harris

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P009384 Issued in NC

Practice address

4064 Race Track Rd
Grifton, NC 28530-7304

Phone

(252) 523-4687

NPI assigned

Mar 12, 2015

Last updated

Sep 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Integrated Family Services PLLC

  • Community/Behavioral Health Agency
  • Ahoskie, NC
  • NPI 1942289244

  Clinical

  Medicare reassignment NPD
• Life Touch LLC

  • Community/Behavioral Health Agency
  • Kinston, NC
  • NPI 1487882205
  Medicare reassignment NPD
• Integrated Family Services PLLC

  • Clinical Social Worker
  • Elizabeth City, NC
  • NPI 1629205208
  NPD

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473897600000",
    "number": "1417340688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4064 RACE TRACK RD",
            "city": "GRIFTON",
            "state": "NC",
            "postal_code": "285307304",
            "telephone_number": "252-523-4687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4064 RACE TRACK RD",
            "city": "GRIFTON",
            "state": "NC",
            "postal_code": "285307304",
            "telephone_number": "252-523-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2016-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "21642A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P009384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amariana Zy'Naye Clemons
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• Dixon House LLC
• Allison Frazer
• Graham Stancil Justice Jr., CSFA
• L&C Family Care Home
• Daniqua Leary
• Patrina Enterprise LLC
• Physicians East, PA

• Clinical Social Worker in Grifton, NC
• Providers in Grifton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.