Nicole Lee Harriman, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

21375 Issued in MN

Practice address

4884 Miller Trunk Hwy Ste 100
Hermantown, MN 55811-2836

Phone

(218) 812-3600

Fax

(218) 309-0198

NPI assigned

Mar 18, 2013

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Threesixty LLC

  • Clinical Social Worker
  • Hermantown, MN
  • NPI 1427662592
  NPD Authorized official

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1457693459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4884 MILLER TRUNK HWY STE 100",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112836",
            "telephone_number": "218-812-3600",
            "fax_number": "218-309-0198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4884 MILLER TRUNK HWY STE 100",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558112836",
            "telephone_number": "218-812-3600",
            "fax_number": "218-309-0198"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "324 W Superior St Ste 600",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558021722",
            "country_code": "US",
            "telephone_number": "218-606-1797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIMAN",
        "first_name": "NICOLE",
        "middle_name": "LEE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21375",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "21375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457693459",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH-MEDICA",
            "identifier": "1457693459",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alyson Halverson
• Ella S Hanhan
• Craig Scott Hansen
• Caleb Todd Hanson
• Chelsey Marie Harju, LICSW
• Harrington Endodontics
• Bernard W Harrington, DDS
• Haille Frances Harrington
• Pamela P Harrington, DDS MS
• Shelby Marie Harris, BA

• Social Worker in Hermantown, MN
• Providers in Hermantown, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.