Individual provider Active NPI

Melissa Harris, LCSW

  • Clinical Social Worker
  • Watseka, IL
National Provider Identifier
1588065908
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149028105 Issued in IL
Practice address
806 E Walnut St
Watseka, IL 60970-1583
Phone
(815) 432-1078
Fax
(815) 432-1079
NPI assigned
Sep 5, 2014
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 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 149028105 IL Primary

Addresses

Primary practice location

806 E Walnut St
Watseka, IL 60970-1583

Mailing address

1120 N Melvin St
Gibson City, IL 60936-1477
Phone (217) 784-4251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250331002833 IL Practitioner - Clinical Social Worker 7719400704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

806 E Walnut St
Suite a
Watseka, IL 60970-1584
Phone (815) 432-1078

912 W Seminary Ave
Onarga, IL 60955-1401
Phone (815) 268-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149028105ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association CurrentSince Mar 24, 2025 Accepting new patients
Gibson Community Hospital Association CurrentSince Mar 1, 2025 Accepting new patients
Gibson Community Hospital Association CurrentSince Mar 1, 2025 Accepting new patients

Locations

10 Doctors Park
Gibson City, IL 60936
Phone (217) 784-2650

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

7 Doctors Park
Gibson City, IL 60936
Phone (217) 784-5500

323 W Mulberry St
Watseka, IL 60970
Phone 8152694769201

806 E Walnut St
Watseka, IL 60970
Phone (815) 432-1078

806 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-1078

Interoperability endpoints

  • Direct secure messaging: melissa.harris.p27@direct.gapho.nextgenshare.com

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": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1588065908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N MELVIN ST",
            "city": "GIBSON CITY",
            "state": "IL",
            "postal_code": "609361477",
            "telephone_number": "217-784-4251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E WALNUT ST",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701583",
            "telephone_number": "815-432-1078",
            "fax_number": "815-432-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149028105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.