Individual provider Active NPI

Quinten Lee Harris Jr., MSW, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1417677113
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
260336 Issued in KY
Practice address
3150 Custer Drive Suite 202
Lexington, KY 40517
Phone
(502) 219-3488
Fax
(502) 406-5803
NPI assigned
Sep 1, 2022
Last updated
May 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2025

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 260336 KY Primary

Addresses

Primary practice location

3150 Custer Drive Suite 202
Lexington, KY 40517

Mailing address

3150 Custer Dr Ste 202
Lexington, KY 40517-4010
Phone (502) 219-3488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250630001070 KY Practitioner - Clinical Social Worker 4880107267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2101 Nicholasville Rd
Suite 304
Lexington, KY 40503-2526
Phone (859) 277-5771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Services, LLC CurrentSince Jun 17, 2025 Accepting new patients
Kentucky Services, LLC CurrentSince Jun 17, 2025 Accepting new patients

Locations

3150 Custer Dr
Ste 202
Lexington, KY 40517
Phone (502) 219-3488

3150 Custer Dr
Ste 203
Lexington, KY 40517
Phone (502) 219-3488

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1417677113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DR STE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174010",
            "telephone_number": "502-219-3488",
            "fax_number": "502-406-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 CUSTER DRIVE SUITE 202",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40517",
            "telephone_number": "502-219-3488",
            "fax_number": "502-406-5803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "QUINTEN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-01",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "260336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.